GESTATIONAL DIABETES MELLITUS

Gestational Diabetes Mellitus (GDM) is one of the most frequent metabolic diseases during pregnancy and approximately affect of all pregnancies. It is also a significant predictor for type 2 diabetes. Reported risk factors for GDM recurrence include maternal age, ethnicity, BMI, weight gain between pregnancies, insulin use, parity, macrosomia, inter-pregnancy interval (IPI), and the oral glucose tolerance test (OGTT) levels. It was found that among other risk factors, the third trimester mean glucose levels were higher in women in whom GDM recurred in the next pregnancy compared with women without GDM recurrence. Outside of pregnancy, screening for clinically important levels of hyperglycaemia is generally recommended only for individuals with specific risk profiles. The first is a simple 1 h glucose challenge test to identify a large number of women at very low risk of clinically important hyperglycaemia; they do not need additional testing. The second step is a more complex 2 h or 3 h oral glucose tolerance test applied to the ‘at risk’ women to define the subset who have GDM.

According to a study it is concluded that postprandial levels during pregnancy have a lasting effect and can reflect the next pregnancy’s glycaemic profile. Since GDM recurrence by itself is a risk factor for type 2 diabetes mellitus, it will be interesting to explore the postprandial levels during pregnancy as a risk factor for type 2 diabetes.

Understanding the genetic and pathophysiological underpinnings of these differences may be useful in developing more targeted approaches to preventing GDM and preventing diabetes mellitus after GDM in mothers and their offspring.