ADIPS Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Overt Diabetes in Pregnancy: Clinical Implications and Outcomes       (#110)

Tang Wong 1 2 3 , Jenny Wright 1 , Quynh Le 1 , Cunjing Li 1 , Androulla Georgiou 1 , Jessica Barlogie 1 , Wenjie Wang 1 , Mikey Xie 1 , Sarah Abdo 1 3 , Kajanan Parameshwaran 1 , Fatima Iqbal 1 , Jeff Flack 1 2 3
  1. Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia
  2. University of NSW, Sydney, NSW, Australia
  3. Western Sydney Univerisity, Sydney, NSW, Australia

Background:

We hypothesised that women with Overt Diabetes in pregnancy(ODM) have comparable risks of adverse outcomes to those with pre-gestational Type 2 diabetes(T2D).


Aim:

To compare the risk of adverse pregnancy outcomes in T2D, ODM and GDM.

 

Methods:

We analysed prospectively collected data from singleton pregnancies(1992–April 2025) involving GDM(n=7497), ODM(n=605), and T2D(n=302). ODM was defined as fasting glucose≥7.0 mmol/L, 2-hr≥11.1mmol/L(on OGTT), or HbA1c≥6.5%. Outcomes included insulin use, caesarean section(CS), preterm birth(<37 weeks), LGA, SGA, neonatal hypoglycaemia(NH), jaundice, and shoulder dystocia(ShD).

 

Results:

Compared to GDM, both ODM and T2D women had higher maternal age, gravida, parity(all p<0.0001). There were fewer East/South-East-Asian women among ODM and T2D compared to GDM(p<0.001 and <0.0001, respectively). Compared to ODM, T2D women had higher Maternal age(p<0.0001), pre-pregnancy BMI(p<0.0001), gravida(p<0.05), parity(p<0.05), with more Middle-Eastern women (p<0.05)-Table1.

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Consistent with our previous study[1], many ODM women were normoglycaemic post-partum(46.4%).


LGA was higher in ODM(25.3%), and T2D(25.5%) compared to GDM(12.6%) [both, p<0.0001]. Neonatal jaundice and ShD were higher in ODM(1.7%) and T2D(2.9%), compared to GDM(0.6%)[p<0.01and<0.0001, respectively]. There were no significant differences in LGA or ShD rates between T2D and ODM. 

Insulin use, pre-term delivery, and NH were higher in T2D and ODM, compared to GDM(all p<0.0001), and significantly higher in T2D compared to ODM (p<0.0001,<0.001 and <0.0001, respectively)-Table2.

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Conclusions:

ODM represents a state of intermediate risk between GDM and T2D regarding insulin use, pre-term delivery, CS and NH. Rates of LGA, neonatal jaundice and ShD are comparable between ODM and T2D. Hence ODM warrants similar surveillance to T2D.

       

     
  1. 1. Wong, T., et al., The clinical significance of overt diabetes in pregnancy.[Erratum appears in Diabet Med. 2013 Jul;30(7):887]. Diabetic Medicine, 2013. 30(4): p. 468-74.