Risk of diabetes mellitus after gestational diabetes - review. Part I. Risk of diabetes mellitus after gestational diabetes

Abstract

A diagnosis of gestational diabetes often predicts future glucose homeostasis complications. Women with GDM in one pregnancy are at risk for development of glucose metabolism disturbances in a subsequent gestation. GDM has also been associated with a likelihood of subsequent diabetes in the nonpregnant state, which risk depends on the time since delivery. Earlier gestational age at diagnosis of gestational diabetes, high fasting and 2 h glucose level on the pregnancy oral glucose tolerance test (OGTT), high fasting and postprandial glucose level during pregnancy, need for insulin therapy during pregnancy, presence of autoimune markers of beta-cells destruction, macrosomic fetus, abnormal outcome of 6 weeks postpartum OGTT and number of gestational diabetic pregnancies were found to be most predictive of subsequent abnormal glucose metabolism. Age, gravidity, presence of diabetes in first-degree relatives, increased prepregnancy body mass index, maternal overweight at followup, weight gain after the GDM pregnancy, ethnic group, dyslipidemia (mainly: increased triglicerides, total cholesterol, LDL-cholesterol and decreased HDL-cholesterol), high fat diet also are associated with glucose intolerance in future life.