Strengths and Limitations
To the best of our knowledge, our study is the first to evaluate
1st trimester FPG levels and its association with T2DM
up to 5-year follow-up. The strengths of this study include the large
cohort and the linkage of two detailed databases with systematic data
collection measured rather than reported. Our results were based
directly on the laboratory glucose levels and INDR solid criteria and
not on reported GDM or T2DM diagnosis. Nevertheless, our study was not
free of limitations, mainly derived from its retrospective nature. 1)
our study did not involve a structured GDM or T2DM screening, therefore,
it may be biased by women selected to be screened. 2). The Meuhedet HMO
pregnancy registry has been limited to the last five years, therefore we
lack data on longer postpartum follow-ups. Also, the registry lacked
data on other major GDM and T2DM risk factors, such as gestational
weight gain, ethnicity, a family history of T2DM, lipid profile, or
possible after-pregnancy interventions including weight reduction or
lifestyle modifications that might have interfered with the risk for
T2DM. 3) we did not account for women who might have been offered
self-monitoring of glucose values and therefore were excused from the
oGTT for the diagnosis of GDM. This shortcoming could have led to an
underestimation of the size effect.