The Inter- and Intragenerational Impact of Gestational Diabetes on the Epidemic of Type 2 Diabetes

Abstract

GDM may be an important driver for the T2DM epidemic in many subpopulations. Because GDM is a readily identifiable, preventable, and treatable condition, investments in prevention, rapid diagnosis, and evidence-based treatment of GDM in at-risk populations may offer substantial benefit in lowering the T2DM burden over many generations. Model-informed data collection can aid in assessing intervention tradeoffs.

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

“…Studies overseas suggest Indigenous women at highest risk of glucose intolerance may be less likely to return for postpartum diabetes screening [42]. Delayed diagnosis and treatment of type 2 diabetes also pose serious risks to subsequent pregnancies in the short term for both Indigenous and non-Indigenous women, including congenital abnormalities [43,44], shoulder dystocia, macrosomia [13,45], neonatal intensive care admissions, and hypoglycaemia [46][47][48]; and increased risks for the infant in the longer term of obesity, hyperglycaemia, type 2 diabetes and renal disease [14,[49][50][51][52][53][54]. Undiagnosed and untreated diabetes also poses serious risks for the mother, including caesarean section [55], heart disease, stroke, renal disease, kidney failure, limb amputations and blindness [56].…”

“…Women diagnosed with gestational diabetes have a very high risk of developing type 2 diabetes mellitus (type 2 diabetes) postpartum (approximately 25 % within 15 years) [10], more than seven-times the risk among women without gestational diabetes [11], with Indigenous women having the highest risk [5,12]. This emergence of diabetes among young child-bearing women represents an ominous stage in the diabetes epidemic, as exposure to diabetes in utero compounds the risk for the next generation [13,14], and gestational diabetes becomes an additional driver for type 2 diabetes [14,15].…”

Diabetes in pregnancy—a critical window of opportunity

“…Babies born to mothers with gestational diabetes also have a higher lifetime risk of obesity and developing type 2 diabetes. GDM may be responsible for 19-30% of diabetes in some populations [13]. About one third of children born of diabetes pregnancies develop glucose intolerance before the age of 17 years [14].…”

Towards a European Consensus on Gestational Diabetes Mellitus: A Pragmatic Guide for Diagnosis, Management, and Care. The Polish Diabetes in Pregnancy Study Group and FIGO

“…Children born to women with HIP are also at very high risk of obesity, early onset type 2 diabetes and cardiovascular disease whereby, www. journals.viamedica.pl/ginekologia_polska HIP perpetuates these conditions into the next generation [11][12][13].…”