{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:16:42Z","timestamp":1783653402872,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To account for the heterogeneity of gestational diabetes (GDM), this study investigated tailored predictors during pregnancy and at 6-8 weeks postpartum of glucose intolerance (GI) at 1-year postpartum. We identified predictors according to data-driven clusters, analogous to the newly proposed diabetes classification, and for clinical ease also based on BMI-categories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a secondary analysis of the MySweetheart trial. It included 179 women with GDM who underwent a 75g oral glucose tolerance test and HbA1c measurement at 1-year postpartum. Predictors were determined according to: a) cluster analysis based on age, BMI, HOMA-IR and HOMA-B; and b) BMI-categories (normal weight [NW], and overweight\/obesity [OW\/OB]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified two clusters during pregnancy and at 6-8 weeks postpartum (for both time points an \u201cinsulin-resistant\u201d, and an \u201cinsulin-deficient\u201d cluster). The \u201cinsulin-resistant\u201d cluster was associated with a 2.9-fold (CI: 1.46-5.87; pregnancy) and 3.5-fold (CI: 1.63-7.52; at 6-8 weeks postpartum) increased risk of GI at 1-year postpartum. During pregnancy, the most relevant predictors of GI were history of previous GDM and fasting glucose for the \u201cinsulin-deficient\u201d and NW category and HOMA-IR for the \u201cinsulin-resistant\u201d and OW\/OB category (all p \u22640.035). In the postpartum, predictors were more heterogenous and included the insulin-sensitivity-adjusted-secretion index and 1-h glucose in the \u201cinsulin-deficient\u201d and NW women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main conclusions<\/jats:title><jats:p>In women with GDM, we identified \u201cinsulin-resistant\u201d and \u201cinsulin-deficient\u201d clusters with distinct risks of future GI. Predictors varied according to clusters or BMI-categories emphasizing the need for tailored risk assessments.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1381058","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T04:52:21Z","timestamp":1721105541000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Postpartum glucose intolerance after gestational diabetes mellitus: tailored prediction according to data-driven clusters and 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