Women with previous gestational diabetes mellitus are an appropriate population in which to direct efforts at diabetes prevention because of the increased risk of developing type 2 diabetes in later years. GDM is also associated with increased risk of obesity and abnormal glucose metabolism during childhood and adult life in the offspring.
Gestational diabetes mellitus (GDM) is common and, like obesity and type 2 diabetes that are related conditions, is increasing in frequency throughout the world. The risk of developing diabetes after GDM is very high. Recently completed research studies as well as ongoing studies promise important advances in the diagnosis and treatment of GDM.
Women with previous GDM are an appropriate population in which to direct efforts at diabetes prevention because of the increased risk of developing type 2 diabetes in later years. Recent results from a randomized clinical trial (RCT) confirm that treating ‘mild GDM’ decreases the risk of adverse perinatal outcome 1 . Studies currently in progress hold much hope of providing the data from which 'outcome based' diagnostic criteria and appropriate strategies for the detection of GDM can be developed.
The risk of progressing to diabetes after GDM can be greatly reduced or delayed by moderate, sustained improvement in lifestyle or with medication in women who have impaired glucose tolerance (IGT).There have not been randomized clinical trials to determine if GDM can be prevented in women at ‘high risk’ for its development during pregnancy (obese, strong family history of type 2 diabetes, member of an ethnic group with a high prevalence of type 2 diabetes). However, epidemiological data suggest that sustaining a healthy lifestyle would also reduce the risk of GDM in ‘high risk’ individuals.
1.Crowther,C.A. Hiller,F.E. Moss,J.R. McPhee,A.J. Jeffries,W.S. Robinson,F.S. for the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med.2005; 352(24): 2477-2486