Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study

•This is the first prospective study of type 2 diabetes among First Nations women after gestational diabetes (GDM).•First Nations Australian women with GDM have a high cumulative incidence of type 2 diabetes (22%) 2.5 years postpartum.•Risk for postpartum diabetes includes age, multiparity, higher glucose values, insulin use and body mass index (BMI).•We highlight a need for policies on postpartum screening developed in partnership with First Nations women with GDM. To determine among First Nations and Europid pregnant women the cumulative incidence and predictors of postpartum type 2 diabetes and prediabetes and describe postpartum cardiovascular disease (CVD) risk profiles. PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Ethnic-specific rates of postpartum type 2 diabetes and prediabetes were reported for women with diabetes in pregnancy (DIP), gestational diabetes (GDM) or normoglycaemia in pregnancy over a short follow-up of 2.5 years (n = 325). Pregnancy characteristics and CVD risk profiles according to glycaemic status, and factors associated with postpartum diabetes/prediabetes were examined in First Nations women. The cumulative incidence of postpartum type 2 diabetes among women with DIP or GDM were higher for First Nations women (48%, 13/27, women with DIP, 13%, 11/82, GDM), compared to Europid women (nil DIP or GDM p