Risk of diabetes mellitus after gestational diabetes - review. Part II. Predisposition to diabetes mellitus and postparum care of women with previous gestational diabetes

Abstract

Gestational diabetes mellitus with impaired fasting glucose and impaired glucose tolerance increase risk of developing overt diabetes later in life. Obesity increased the risk of diabetes type 2. Inslet cell antibodies are markers for subject at risk for type 1 diabetes melitus after GDM. Women with previous GDM also have a high risk of insulin metabolic syndrome: increased BMI, dyslipidemia, hypertension and subsequently increased risk of atherosclerosis and coronary heart disease. The primary goal in the care of women with previous GDM is to prevent the development of diabetes and diabetic sequelae. All women after GDM should have a regular assessment of their glucose tolerance in the years after pregnancy. Currently, there are no recommended medical strategies to prevent the development of diabetes in women with previous GDM. The current glycemic status of women with recent GDM should be established (oral glucose tolerance test) at the postpartum visit and then, at minimum, every 2–4 years thereafter. Equally important is the long-term lifestyle changes (nutritional managenent and exercise programs) that may maintain or achieve normal or reasonable body weight.