Objective: To evaluate which immigrant groups to Canada are at increased risk of diabetes (DM) after gestational diabetes (GDM), including the influence of time since migration.
Research Design and Methods: This retrospective cohort study used administrative data within a universal healthcare system. Included were women with GDM who had given birth in Ontario, Canada, 2006-2014. Women from each World region were compared to native-born/long-term residents of Canada for risk of DM using Cox regression. Results were further evaluated by time since immigration (0-5, 5-10, 10-20 years vs. native-born/long-term residents [referent]), adjusting for age at index pregnancy, income, BMI, parity and any hypertensive disorder of pregnancy.
Results: A total of 8630 women with GDM were followed for a median of 4.9 years. Relative to native-born/long-term residents (incidence rate 29.2 person-years), the age-adjusted hazard ratios (aHR) for DM were higher among women from South Asia (1.28, 95% confidence interval, CI 1.20-1.36), Latin America/the Caribbean (1.42, 95% CI 1.28-1.57), and Sub-Saharan Africa (1.59, 95% CI 1.39-1.83). Relative to native-born/long-term residents, the aHR for DM were 1.42 (95% CI 1.20-1.67) for those residing 0-5 years, 1.19 (95% CI 1.00-1.42) 5-10 years, and 1.41 (95% 1.20-1.65) 10-20 years since immigration.
Conclusions: Certain broadly-defined immigrant groups are at a significantly higher future risk of developing diabetes after having GDM, especially those who are recent immigrants.
J. S. S. Ho: None. L. Lipscombe: None. S. H. Read: Employee; Self; Certara. L. Rosella: None. H. Berger: None. D. Feig: Advisory Panel; Self; Novo Nordisk. K. Fleming: None. J. G. Ray: None. B. R. Shah: None. S. Sarma: None.