Risk Factors and Management for the Recurrent Gestational Diabetes Mellitus: A Narrative Review

Abstract

Objectives: Recurrent gestational diabetes mellitus (RGDM) is a frequently encountered condition marked by a prior occurrence of one or more episodes of gestational diabetes mellitus (GDM). After delivery, there is a period of normal blood glucose levels, followed by the reappearance of abnormal glucose metabolism in a subsequent pregnancy. Emerging evidence suggests that factors such as a history of GDM, advanced maternal age, delivery of macrosomia, as well as alterations in dietary and lifestyle choices, can significantly increase the risk of recurrence of GDM in subsequent pregnancies. In fact, recurrence rates have been reported to reach as high as 84%. The purpose of this review is to demonstrate the risk factors and management strategies for RGDM in pregnant women. Mechanism: In order to investigate the evidence for RGDM, a comprehensive computerized literature search was conducted on PubMed, Web of Science, Wiley Online Library, and China National Knowledge Infrastructure (CNKI) up to 1 January 2024. The search aimed to identify relevant studies focusing on the clinical risk factors associated with RGDM, including maternal age, weight, body mass index (BMI), history of GDM, and other indicators. The findings of this search provide a detailed summary of these observed risk factors. Findings in Brief: Age, BMI, and weight gain during pregnancy, the interval between pregnancies, previous history of GDM, oral glucose tolerance test (OGTT) results, history of macrosomia, insulin levels, dietary patterns, lifestyle changes, and breastfeeding, all have an impact on the recurrence rates of GDM. It is crucial to investigate these risk factors, whether GDM recurs or not, in order to improve the prevention and management of GDM. Conclusions: A number of common factors influence the recurrence rate of GDM, including age, BMI, inter-pregnancy weight gain, and a previous history of GDM. Thorough examination of a substantial body of research has provided insights into these factors. The implementation of preventative and therapeutic strategies for recurrent GDM relies on attention to risk factors and glycemic status. Additionally, this study provides a concise overview of RGDM.