Gestational diabetes & diabetes in pregnancy
Gestational diabetes and subsequent risk of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease in a commercially insured U.S. Pregnancy cohort
Authors' conclusion
In this claims-based cohort, GDM confers increased risk of T2D and MASLD, with most excess MASLD risk acted through T2D. Postpartum strategies prioritizing diabetes prevention may markedly attenuate liver disease burden in this high-risk population.
Study context
- Population
- Females aged 12–55 years with ≥ 20 gestational weeks and continuous enrollment from 90 days pre-pregnancy through ≥ 1 year postpartum, MerativeTM MarketScan® Commercial Database (2007–2023)8.43% had gestational diabetes mellitus (GDM)
- Participants
- 1,363,040 females
- Exposure
- GDM vs no GDM
- Outcome
- Claims-diagnosed incident T2D and MASLD after delivery
- Follow-up
- Up to 15 years; mean 3.1 years
Methodological detailsclaims-based, Cox models, semi-Markov multistate model
- Claims-based
- Cox models
- semi-Markov multistate model
Main finding
As reported in the abstract
Each group vs no GDMEstimate (95% CI)
GDM
aHR (T2D) 11.96(11.55–12.38)
GDM
aHR (MASLD) 2.29(2.15–2.43)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Direct GDM-to-MASLD association (multistate model) | 2.16 (2.02–2.31) | |
| 0.512Hazard ratio (log scale) |
Direct GDM-to-MASLD association (multistate model)
- Dominant indirect pathway through T2D
Projected 5-year MASLD risk (model-based counterfactual)
- Projected 5-year MASLD risk without GDM
- 0.45%
- Preventing post-GDM T2D reduced projected 5-year MASLD risk from 13.30% to 0.93%
Original publication
Gestational diabetes and subsequent risk of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease in a commercially insured U.S. Pregnancy cohort. Diabetes Res Clin Pract. Published 3 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →