Are insulin sensitivity and β-cell function associated with adverse pregnancy outcomes among women with gestational diabetes?

Abstract

Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is a common pregnancy outcome. [1] GDM carries risks for the mothers, and fetus, neonate, and childhood in the offspring. Women with GDM may increase risks of high blood pressure and preeclampsia during pregnancy, primary cesarean section, and future obesity, hypertension, dyslipidemia, metabolic syndrome, and cardiovascular disease. [2][3][4][5][6] About 20-50% of women with prior GDM will develop type 2 diabetes within 3-5 years of pregnancy, and 70% will develop type 2 diabetes if followed ≥10 years. [7][8][9] More alarming, children exposed to GDM in utero have a series of adverse pregnancy outcomes at birth including preterm delivery, excessive birth weight, and low blood sugar, and also have higher risks of obesity, [10] impaired glucose tolerance and type 2 diabetes, [10] high blood pressure, [11] and dyslipidemia later in life. [12] Thus, GDM likely contributes to the vicious intergenerational cycle of obesity and type 2 diabetes. [13]