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Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Ponnusamy Saravanan, University of Warwick
- Second opponent: Senior Scientist Louise Groth Grunnet, Steno Diabetes Center Copenhagen, Denmark
- Third member and chair of the evaluation committee: Associate Professor Aud Høieggen, University of Oslo
Chair of the Defence
Professor Pål Gulbrandsen, University of Oslo
Principal Supervisor
Professor Kåre Inge Birkeland, University of Oslo
Summary
The long-term risk of type 2 diabetes after gestational diabetes mellitus is twice as high in South Asian than in European women. Additionally, South Asian women develop type 2 diabetes at an earlier age and at a lower body mass index than European women. Despite this increased risk, too few women attend the recommended screening after a pregnancy with gestational diabetes mellitus.
In this dissertation, we examined South Asian and Nordic women with previous gestational diabetes by oral glucose tolerance tests and focus group interviews 1-3 years after their delivery. We aimed to characterise ethnic differences in prevalence rates and early predictors of prediabetes and diabetes, and to advance knowledge about behavioural and pathogenetic factors behind South Asian women’s higher risk of diabetes short time after delivery.
In South Asian and Nordic women with gestational diabetes mellitus, we found that one in two South Asian and one in five Nordic women had prediabetes or diabetes few years after their delivery. The higher risk among South Asian women was associated with lower beta cell function, lower fasting hepatic insulin clearance, and lower insulin sensitivity. Notably, normoglycaemic South Asian women displayed a phenotype very similar to Nordic women with prediabetes or diabetes. This dissertation reinforces the need for more organised public healthcare with tailored information to reduce women’s future diabetes risk after gestational diabetes mellitus, particularly in South Asian women. Our data imply that ethnic difference in body composition is important for the progression from normoglycaemia to prediabetes or diabetes after gestational diabetes mellitus.
Overall, our novel observations add to our understanding of diabetes pathophysiology in South Asians and whites in general, and in the context of previous GDM.
Additional information
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