The Diabetes & Womens Health Study, based on a innovative hybrid design combining new prospective data collection with historical data, aims to understand pathways and determinants underlying the progression from gestational diabetes (GDM) to type 2 diabetes (T2DM) and complications such as cardiovascular diseases. GDM is a common pregnancy complication. Women who develop impaired glucose tolerance and/or GDM in pregnancy are at substantially increased risk for T2DM in the years following pregnancy. Determinants underlying the transition from GDM to T2DM are not well studied and available studies are limited. There is limited information about the genetic and environmental factors that impact this transition in particular. Further, there is limited research aimed at following women with GDM long term through later adulthood for the development of T2DM and co-morbidities. These critical data gaps serve as the impetus for this study with the overall goal of investigating genetic factors and their interactions with risk factors amenable to clinical or public health intervention in relation to the transition of GDM to T2DM. Data collection for this study will build upon two large existing cohorts: the Nurses' Health Study II (NHS-II) and the Danish National Birth Cohort (DNBC). In the present study, we will enroll approximately 4,000 women with a history of GDM who were members of either the NHS II or DNBC. After enrollment, we will follow participants for an additional four years to collect updated information on major clinical and environmental factors including, but not limited to, diet, physical activity and anthropometric information that may predict T2DM risk; to collect timed biospecimens including blood, urine and toenails to measure genetic and biochemical markers implicated in glucose metabolism. The study made an outstanding progress last year. The first cycle data collection was completed reaching 96% of overall enrollment goal. A web-based data management system has been established to monitor and report the study progress daily and to track biospecimen collection, processing, storage and shipment, allowing the study team to have 24/7 access to the study and data. The second cycle data collection started in September, 2014 and is making good progress. Further study details are available at the Studys website (www.dwhstudy.org). One unique advantage of the hybrid design is the availability of historical data which allows investigators to address relevant research questions and publish findings while pursuing new data collection prospectively. Comprehensive historical datasets with data longitudinally collected over the past 15-20 years from both the NHS II study and DNBC among more than 7500 individuals (with more than 30,000 variables available from each individual) were delivered to the DWH study's data coordinator center (DCC) and transferred to the NICHD in March, 2012. Based on the longitudinal historical datasets, more than 15 analyses and manuscripts have been planned. A couple of manuscripts have been published in high impact medical journals and a few more are in press or under review. Moreover, an offspring cohort proposal built upon the DWH study, aiming to investigate the transgenerational impacts of GDM and obesity in pregnancy on the offspring's health has been developed, presented, and approved by NICHD Director subject to available funding.

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5
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2015
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U.S. National Inst/Child Hlth/Human Dev
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Tobias, Deirdre K; Clish, Clary; Mora, Samia et al. (2018) Dietary Intakes and Circulating Concentrations of Branched-Chain Amino Acids in Relation to Incident Type 2 Diabetes Risk Among High-Risk Women with a History of Gestational Diabetes Mellitus. Clin Chem 64:1203-1210
Rawal, Shristi; Olsen, Sjurdur F; Grunnet, Louise G et al. (2018) Gestational Diabetes Mellitus and Renal Function: A Prospective Study With 9- to 16-Year Follow-up After Pregnancy. Diabetes Care 41:1378-1384
Panuganti, Pranati L; Hinkle, Stefanie N; Rawal, Shristi et al. (2018) Lactation Duration and Long-Term Thyroid Function: A Study among Women with Gestational Diabetes. Nutrients 10:
Zhu, Yeyi; Olsen, Sjurdur F; Mendola, Pauline et al. (2017) Maternal consumption of artificially sweetened beverages during pregnancy, and offspring growth through 7 years of age: a prospective cohort study. Int J Epidemiol 46:1499-1508
Zhu, Yeyi; Olsen, Sjurdur F; Mendola, Pauline et al. (2017) Maternal dietary intakes of refined grains during pregnancy and growth through the first 7 y of life among children born to women with gestational diabetes. Am J Clin Nutr 106:96-104
Li, Shanshan; Zhu, Yeyi; Yeung, Edwina et al. (2017) Offspring risk of obesity in childhood, adolescence and adulthood in relation to gestational diabetes mellitus: a sex-specific association. Int J Epidemiol 46:1533-1541
Tobias, Deirdre K; Stuart, Jennifer J; Li, Shanshan et al. (2017) Association of History of Gestational Diabetes With Long-term Cardiovascular Disease Risk in a Large Prospective Cohort of US Women. JAMA Intern Med 177:1735-1742
Chavarro, Jorge E; Rich-Edwards, Janet W; Gaskins, Audrey J et al. (2016) Contributions of the Nurses' Health Studies to Reproductive Health Research. Am J Public Health 106:1669-76
Li, Shanshan; Zhu, Yeyi; Chavarro, Jorge E et al. (2016) Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study. Hypertension 67:1157-65
Ley, Sylvia H; Ardisson Korat, Andres V; Sun, Qi et al. (2016) Contribution of the Nurses' Health Studies to Uncovering Risk Factors for Type 2 Diabetes: Diet, Lifestyle, Biomarkers, and Genetics. Am J Public Health 106:1624-30

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