Title:Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes
Volume: 26
Issue: 43
Author(s): Eleni Kousta*, Adamantia Kontogeorgi, Stephen Robinson and Desmond G. Johnston
Affiliation:
- Research in Female Reproduction Postgraduate Course, National and Kapodistrian University of Athens Medical School, Athens,Greece
Keywords:
Gestational diabetes, type 2 diabetes, metabolic consequences, definition, screening, cardiovascular disease, prevalence.
Abstract: Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines
on gestational diabetes have been impeded by the long-term controversies on its definition and screening
strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity
and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has
important long-term implications, including gestational diabetes recurrence, increased risk for developing type
2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be
viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique
opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular
disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines
are briefly described and metabolic and cardiovascular long-term consequences of women with a history
of gestational diabetes are summarized. A summary of our own St. Mary’s Hospital-UK Research series on
long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic
groups and 482 control women is also included. We found that approximately 2 years following delivery, 37%
of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly,
even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future
research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification
of pre-pregnancy predictors and risk reduction before conception.
