Impact of an Additional Pregnancy on the Natural History of Insulin Sensitivity, β-Cell Function, and Glycemia in Parous Women
Authors' conclusion
Pregnancy is associated with worsening of the long-term trajectory of insulin sensitivity, revealing both a pathophysiologic basis for enhanced diabetes risk and a target for risk modification.
Study context
- Population
- Parous women assessed at 1 year postpartum and on ≥3 occasions over the following decade
- Participants
- 303 women
- Exposure
- Additional pregnancy vs no additional pregnancy
- Additional pregnancyn = 78
- No additional pregnancyn = 225reference
- Outcome
- Trajectories of insulin sensitivity/resistance (Matsuda index; HOMA-IR), β-cell function (ISSI-2; insulinogenic index/HOMA-IR) and glycemia
- Follow-up
- 10 years
Methodological detailslinear mixed-effect models adjusted for diabetes risk factors, serial OGTT over 10 years
- Linear mixed-effect models adjusted for diabetes risk factors
- Serial OGTT over 10 years
Main finding
As reported in the abstract
10-year trajectory of Matsuda index, β-cell function and glycemia
- No differences in trajectories of β-cell function and glycemia
- Additional pregnancy vs No additional pregnancy: time-group interaction P = 0.02
- Covariate-adjusted
Observational data: associations, not effects.
Further findings
| Outcome | Estimated adjusted average difference | |
|---|---|---|
| Insulin sensitivity (Matsuda index), adjusted · baseline | 1.64 (95% CI 0.22–2.86) | |
| Insulin sensitivity (Matsuda index), adjusted · 1.5 years | 1.28 (CI −0.15 to 2.50) | |
| −2024Difference (linear scale) |
Insulin sensitivity (Matsuda index), adjusted · 1.5 years
- Difference disappeared by 3.5 and 5.5 years
Baseline characteristics
- Additional pregnancy: younger (P < 0.001) and more likely primiparous (P < 0.001)
Original publication
Impact of an Additional Pregnancy on the Natural History of Insulin Sensitivity, β-Cell Function, and Glycemia in Parous Women. Diabetes Care. Published 18 February 2026. doi:10.
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