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Topical Area: Dietary Patterns

Dietary Patterns (Poster Session)

(P14-052-23) Inflammatory and Insulinemic Dietary Patterns and Risk of Type 2 Diabetes Among Women With a History of Gestational Diabetes Mellitus

Sunday, July 23, 2023

11:45 AM - 12:45 PM ET

Location: Poster Board 52

Presenting Author(s)

PL

Peipei Liu, PhD

Postdoctoral Research Fellow
National University of Singapore
Singapore, Singapore

Co-Author(s)

Jiaxi Yang, PhD (she/her/hers)

Research Fellow
National University of Singapore
Singapore, Singapore
DL

Dong Hoon Lee, PhD

Postdoc research fellow
Yonsei University
Boston, Massachusetts, United States
LL

Ling-Jun Li, MD, PhD (she/her/hers)

Assistant Professor
Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore
Singapore, Singapore
Wei Wei Pang, PhD (she/her/hers)

Postdoctoral Fellow
National University of Singapore
SINGAPORE, Singapore
Jorge E. Chavarro, MD, PhD

Associate Professor of Medicine, Harvard Medical School
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
Frank B. Hu, MD, PhD

Professor and Chair
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
CZ

Cuilin Zhang, MD PhD

National University of Singapore

Disclosure(s):

Peipei Liu, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Jiaxi Yang, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Ling-Jun Li, MD, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Wei Wei Pang, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Women with a history of gestational diabetes mellitus (GDM) are at exceptionally high risk for type 2 diabetes (T2D) after pregnancy. It is critical to identify modifiable factors for T2D among these women at high risk. We aimed to examine whether proinflammatory and hyperinsulinemic diets were associated with increased risk of T2D among women with a history of GDM.

Methods: We followed 4,507 women with a history of GDM in the Nurses’ Health Study II for incident T2D between 1991 and 2017. Demographics, lifestyle factors including diet, and disease outcomes were updated every 2-4 years. Empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores were calculated using pre-validated methods driven based on relevant inflammatory and hyperinsulinemic biomarkers. Cox regressions were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident T2D, adjusting for major confounders including body mass index (BMI).

Results: A total of 975 women developed T2D during the follow-up of 88,248 person-years. After adjusting for covariates except for BMI, higher EDIP and EDIH scores were associated with increased risk of T2D. Compared with the lowest quintile, adjusted HRs (95% CI) for increasing quintiles for EDIP were 1.07 (0.83, 1.36), 1.41 (1.12, 1.78), 1.62 (1.30, 2.03), and 1.79 (1.44, 2.24), P-trend < 0.001; and 1.29 (1.00, 1.65), 1.50 (1.17, 1.91), 1.83 (1.45, 2.32), and 2.04 (1.61, 2.57) for EDIH (P-trend < 0.001). Additional adjustment for BMI attenuated the associations, but results remained significant: adjusted HRs (95% CI) for increasing quintiles of EDIP were 1.00 (ref), 1.02 (0.79, 1.30), 1.25 (0.99, 1.57), 1.32 (1.06, 1.66), and 1.34 (1.08, 1.68), P-trend=0.002; for EDIH were 1.00 (ref), 1.18 (0.92, 1.51), 1.26 (0.99, 1.61), 1.34 (1.06, 1.70), and 1.36 (1.07, 1.72), P-trend=0.012. Further adjustment for other diet quality indices did not alter the associations of EDIP with T2D materially.

Conclusions: Among women with a history of GDM, those with higher potential for insulin hypersecretion and chronic systemic inflammation based on EDIP and EDIH scores, were associated with increased risks of T2D.

Funding Sources: Funding from NIH