Gestational Diabetes Mellitus and Subsequent Risks of Diabetes and Cardiovascular Diseases: the Life Course Perspective and Implications of Racial Disparities

Association Between Gestational Diabetes Mellitus and Risk of Overall and Site-Specific Cancers (Pancreatic, Liver, Thyroid, Lung): A Systematic Review and Meta-Analysis

Background: Gestational diabetes mellitus (GDM) is a common endocrine and metabolic disorder during pregnancy. However, current studies have not reached a consensus on the correlation between GDM and the risk of developing cancers. Objective: This systematic review and meta-analysis aims to comprehensively evaluate the association between GDM and the risk of overall cancer and cancers at specific sites (pancreatic cancer, thyroid cancer, liver cancer, lung cancer). Methods: A systematic search was conducted in PubMed, Web of Science, Scopus, EMBASE, and Cochrane Library databases from the establishment of the databases to 16 January 2025. Two researchers independently assessed the quality of the included studies using the Newcastle-Ottawa Scale and extracted relevant data. Data were analyzed using STATA Version 17.0. Results: This systematic review and meta-analysis included a total of 8 studies involving 1,936,836 participants. We calculated the pooled hazard ratio (HR) to evaluate the association, and the results showed that the pooled HR for overall cancer risk was 1.16 (95%CI: 1.04-1.28), indicating a significant increase in the risk of overall malignancies among patients with GDM. GDM was also significantly associated with the risk of pancreatic cancer (HR = 2.80; 95%CI: 1.20-6.55), thyroid cancer (HR = 1.21; 95%CI: 1.08-1.36), and liver cancer (HR = 1.33; 95%CI: 1.10-1.61). Additionally, the association between GDM and lung cancer was close to being statistically significant (HR = 1.19; 95%CI: 0.98-1.44). Conclusion: Our study suggests that GDM is associated with an increased risk of overall cancer, as well as pancreatic cancer, thyroid cancer, and liver cancer.

Gestational Diabetes Mellitus, Breastfeeding, and Progression to Type 2 Diabetes: Why Is It So Hard to Achieve the Protective Benefits of Breastfeeding? A Narrative Review

Women diagnosed with gestational diabetes mellitus (GDM) face a significantly heightened risk of developing type 2 diabetes mellitus (T2DM) later in life. Breastfeeding (BF) has been identified as a potential strategy to delay or prevent T2DM; however, women with GDM often encounter barriers in initiating and maintaining adequate BF practices compared to those with uncomplicated pregnancies. This paradox prompts an exploration into the causes of these BF challenges and considers the possibility of reverse causation: Does prolonged and intensive BF mitigate the risk of subsequent glucose dysregulation and T2DM? Alternatively, do women with compromised insulin secretion and sensitivity, who are predisposed to T2DM, struggle to sustain intensive BF practices? This narrative review aims to explore the interplay between GDM, BF, and T2DM development by examining the different factors that present BF challenges among women with GDM. Understanding these dynamics is crucial for establishing realistic BF expectations and developing effective clinical and public health strategies to support BF in this high-risk population.