Gestational Diabetes

Gestational diabetes is diabetes that develops during pregnancy. Our research demonstrates the urgency of early detection and effective treatment, and explores long term consequences.

Current Studies
Recent Publications

Gestational weight gain and risk of gestational diabetes in preterm delivery

We propose to conduct a cohort study among the estimated 11,000 multi-ethnic KPNC health plan members who completed a detailed survey as part of the RPGEH in 2007 and had a subsequent live birth delivered up to 2011. The study aims are 1) To evaluate whether increasing rate of gestational weight gain up to the time of screening for GDM is associated with an increased risk of GDM 2) To examine total rate of gestational weight gain and the risk of preterm birth sub-types: spontaneous preterm birth and medically indicated preterm birth.
Funder: Health Resources and Services Administration
Principal Investigator: Hedderson, Monique

Comparative effectiveness of diabetes prevention strategies in women with GDM

The main goal of this study is to examine the comparative effectiveness of diabetes prevention strategies in women with gestational diabetes on the control of the following conditions: obesity, diabetes, hypertension, dyslipidemia and depression in a real-world practices setting. To achieve this goal, we will conduct a cluster randomized lifestyle program with randomization at the medical center level. A telehealth postpartum lifestyle intervention will be compared to printed education materials mailed during the postpartum (i.e. usual care). We will prospectively identify a diverse population of 2500 women with GDM receiving health care during pregnancy at 30 medical centers.
Funder: Agency for Healthcare Research and Quality
Principal Investigator: Ferrara, Assiamira

Pregravid biomarkers and risk of GDM

To examine pregravid biomarkers of metabolic risk (Adiponectin, HMW adiponectin, CRP, GGT, Fetuin-A and LDL particle size) in relation to risk of GDM, among women who participated in the MHC (1985-1996) and had a subsequent pregnancy in KPNC.
Funder: Nat. Inst. of Child Health and Human Dev.
Principal Investigator: Hedderson, Monique

ARRA Supplement to Lactation and Glucose Tolerance after GDM Pregnancy – SWIFT, Study of Women, Infant Feeding and Type 2 Diabetes

This study examines whether lactation prevents or delays the development of type 2 diabetes in a large, population-based sample of women with a recent pregnancy complicated by GDM in Kaiser Permanente Northern California.
Funder: Nat. Inst. of Child Health and Human Dev.
Principal Investigator: Gunderson, Erica

Breastfeeding and Infant Growth among GDM Offspring – SWIFT Offspring Study

This Clinical Research Award prospectively examines the relation of infant feeding method (breastfeeding intensity and duration) to growth and adiposity during the first year of life among the offspring of women with GDM, and changes in postpartum adiposity in their mothers in Kaiser Permanente Northern California.
Funder: American Diabetes Association
Principal Investigator: Gunderson, Erica

Risk and Risk Factors of Gestational Diabetes Mellitus (GDM) in a Subsequent Pregnancy

This study seeks to determine the risk and the risk factors of gestational diabetes mellitus (GDM) at a subsequent pregnancy among 48,000 women from the Kaiser Permanente Northern California GDM registry who had at least two pregnancies between 1995 and 2005.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator: Ferrara, Assiamira

Translational Diabetes Prevention in Gestational Diabetes Mellitus (GDM)

This study aims to implement and evaluate an intervention of diet and physical activity among women with GDM, that starts during pregnancy and continues after pregnancy with the primary goals reaching prepregnancy weight if women had normal weight prior to pregnancy; or reaching 5 percent reduction of the prepregnancy body weight if women were overweight or obese prior to pregnancy.
Funder: National Institutes of Health
Principal Investigator: Ferrara, Assiamira

Cohort Study of Pioglitazone and Cancer Incidence in Patients with Diabetes Mellitus

This study explores the potential association between treatment with pioglitazone and risk of cancer at sites other than bladder using information available from a variety of Kaiser Permanente Northern California electronic data sources.
Funder: Takeda Pharmaceuticals North America
Principal Investigator: Ferrara, Assiamira

Lactation Intensity and Postpartum Maternal Glucose Tolerance and Insulin Resistance in Women With Recent GDM: The SWIFT cohort

Gunderson, E. P.; Hedderson, M. M.; Chiang, V.; Crites, Y.; Walton, D.; Azevedo, R. A.; Fox, G.; Elmasian, C.; Young, S.; Salvador, N.; Lum, M.; Quesenberry, C. P.; Lo, J. C.; Sternfeld, B.; Ferrara, A.; Selby, J. V.;
Diabetes Care
Oct 19 2011
PubMed abstract »

Comparison of Hemoglobin A1c With Fasting Plasma Glucose and 2-h Postchallenge Glucose for Risk Stratification Among Women With Recent Gestational Diabetes Mellitus

Kim, C.; Herman, W. H.; Cheung, N. W.; Gunderson, E. P.; Richardson, C.;
Diabetes Care
Jul 12 2011
PubMed abstract »

Pregravid cardiometabolic risk profile and risk for gestational diabetes mellitus

Hedderson, M. M.; Darbinian, J. A.; Quesenberry, C. P.; Ferrara, A.;
Am J Obstet Gynecol
May 26 2011
PubMed abstract »

Change in body mass index between pregnancies and the risk of gestational diabetes in a second pregnancy

Ehrlich, S. F.; Hedderson, M. M.; Feng, J.; Davenport, E. R.; Gunderson, E. P.; Ferrara, A.;
Obstet Gynecol 117 (6): 1323-30
Jun 2011
PubMed abstract »

A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial

Ferrara, A.; Hedderson, M. M.; Albright, C. L.; Ehrlich, S. F.; Quesenberry, C. P., Jr.; Peng, T.; Feng, J.; Ching, J.; Crites, Y.;
Diabetes Care 34 (7): 1519-25
Jul 2011
PubMed abstract »

The risk of large for gestational age across increasing categories of pregnancy glycemia

Ehrlich, S. F.; Crites, Y. M.; Hedderson, M. M.; Darbinian, J. A.; Ferrara, A.;
Am J Obstet Gynecol 204 (3): 240 e1-6
Mar 2011
PubMed abstract »

Strategies for diabetes prevention before and after pregnancy in women with GDM

Ferrara, A.; Ehrlich, S. F.;
Curr Diabetes Rev 7 (2): 75-83
Mar 2011
PubMed abstract »

Longitudinal study of prepregnancy cardiometabolic risk factors and subsequent risk of gestational diabetes mellitus: The CARDIA study

Gunderson, E. P.; Quesenberry, C. P., Jr.; Jacobs, D. R., Jr.; Feng, J.; Lewis, C. E.; Sidney, S.;
Am J Epidemiol 172 (10): 1131-43
Nov 15 2010
PubMed abstract »

Disparities in the risk of gestational diabetes by race-ethnicity and country of birth

Hedderson, M. M.; Darbinian, J. A.; Ferrara, A.;
Paediatr Perinat Epidemiol 24 (5): 441-8
Sep 2010
PubMed abstract »

Maternal and paternal race/ethnicity are both associated with gestational diabetes

Caughey, A. B.; Cheng, Y. W.; Stotland, N. E.; Washington, A. E.; Escobar, G. J.;
Am J Obstet Gynecol
Apr 16 2010
PubMed abstract »

Gestational weight gain and risk of gestational diabetes mellitus

Hedderson, M. M.; Gunderson, E. P.; Ferrara, A.;
Obstet Gynecol 115 (3): 597-604
Mar 2010
PubMed abstract »

Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-Year prospective study in CARDIA

Gunderson, E. P.; Jacobs, D. R., Jr.; Chiang, V.; Lewis, C. E.; Feng, J.; Quesenberry, C. P., Jr.; Sidney, S.;
Diabetes 59 (2): 495-504
Feb 2010
PubMed abstract »