Gestational Diabetes Mellitus: an Opportunity to Prevent Type 2 Diabetes and Cardiovascular Disease in Young Women

Graziano Di Cianni; Alessandra Ghio; Veronica Resi; Laura Volpe

Disclosures

Women's Health. 2010;6(1):97-105. 

In This Article

Future Perspective

Several opportunities exist for the prevention of T2DM and CVD in women with pGDM, such as education regarding risk awareness, implementation of a healthy lifestyle and pharmacological intervention.

Although GDM is a well-established risk factor for T2DM, many women could be unaware of this increased risk. Interventions are clearly needed in order to increase awareness and acceptance of the personal risk of developing T2DM in women with pGDM. Moreover, considering that not only women with GDM, but also those with mild glucose intolerance in pregnancy are at risk of CVD,[57] public education campaigns could be performed for all women with any degree of glucose disturbance during pregnancy.

Postpartum studies of healthy diet and exercise plans should now be performed in women with pGDM in order to determine their potential benefits and to evaluate the most effective way to achieve lifestyle modification in this population. Moreover, considering that breastfeeding is associated with a reduced incidence of T2DM among both women with pGDM and women in the general population,[58] the promotion of a combination of breastfeeding, diet and physical activity could reduce maternal T2DM risk, and might be particularly important in women with pGDM.

Several randomized clinical trials using drugs that improve insulin sensitivity have specifically studied T2DM prevention with pharmacological intervention in women with pGDM.[54–56] Although the results of these studies are promising, it should be noted that these medications are not currently approved for use in T2DM prevention. Additional studies are still needed to evaluate the cost–effectiveness of these medications for the prevention of both T2DM and CVD, alone or in combination with new medications.

Furthermore, all women with pGDM should be offered regular checkups of their glucose tolerance, lipid profile, weight and blood pressure. In order to implement these measures, it is necessary to offer a long-term, continuous programs for these women. Based on the available evidence, a major aim during the next decade will be to implement such programs that might have an important effect on women's health.

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