Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Nicola Hawley

Second Advisor

Shi-yi Wang

Abstract

Objective:To identify risk factors associated with the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM) among women in East Asia. East Asian populations were selected as the focus because previous studies suggest that women in this region may experience a disproportionately high risk of progression after GDM, even at lower body mass index levels than those typically observed in Western populations. A clearer understanding of these risk factors may help inform more targeted postpartum prevention strategies. Methods: A scoping review was conducted using PubMed, Embase, the Cochrane Library, CNKI, VIP, and SinoMed databases, covering studies published from January 1, 2000 to January 16, 2026. The year 2000 was selected to capture studies conducted under more contemporary and comparable diagnostic criteria for GDM and T2DM, while allowing sufficient follow-up time to assess long- term progression. Eligible studies included cohort studies of women with GDM in East Asian populations that reported progression to T2DM. Results: A total of 31 studies were included. Reported cumulative incidence of T2DM after GDM ranged from 2.3% to 43.3% across studies, with variation largely explained by differences in follow-up duration. Identified risk factors included genetic factors (e.g., family history and genetic risk scores), demographic and anthropometric characteristics (e.g., age, BMI, waist circumference), and clinical and biochemical markers such as fasting plasma glucose, 2-hour OGTT glucose, HbA1c, lipid profiles, and other metabolic indicators. Pregnancy-related conditions, including hypertensive disorders and metabolic syndrome, were also associated with increased risk. Conclusion: The progression from GDM to T2DM in East Asian women appears to be influenced by multiple interacting clinical and metabolic factors. Identifying women at higher risk during pregnancy and throughout the postpartum period may support more individualized follow-up and prevention efforts in this population.

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This is an Open Access Thesis.

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