RISK AND PREVENTION OF TYPE-2 DIABETES IN WOMEN WITH GESTATIONAL DIABETES

Women with a history of gestational diabetes mellitus (GDM) are at inc reased risk of future diabetes, predominantly type 2 diabetes, as are their children. The extent of this risk depends both on the diagnostic criteria used to identify GDM and on maternal risk factors, some of w hich are potentially modifiable whereas others are not. The unmodifiab le risk factors are ethnicity pre-pregnancy weight, age, parity, famil y history of diabetes, and degree of hyperglycemia in pregnancy and im mediately postpartum The modifiable risk factors are persistent obesit y future weight gain, and subsequent pregnancies. Additional modifiabl e risk factors in these women are likely to be levels of physical acti vity dietary fat, and avoidance of other lifestyle factors that advers ely influence insulin resistance, such as smoking and certain drus. Di abetic prevention strategies need to address the potentially modifiabl e risk factors using the unmodifiable risk factors to identify women m ost at risk.