Gestational Diabetes Mellitus: Implications for Lifelong Cardiometabolic Health

Gestational diabetes mellitus (GDM) is a common complication during pregnancy, affecting almost one in 10 pregnant individuals in the United States. However, it is important to recognize that GDM is not solely about pregnancy outcomes, but rather a red flag for lifelong cardiometabolic health. Individuals with a history of GDM have an increased risk of developing type 2 diabetes and prediabetes, as well as other cardiometabolic conditions like hyperlipidemia, chronic hypertension, and cardiovascular disease in the long term. The risk of developing prediabetes or type 2 diabetes within 12 months after delivery can be as high as 20 to 30%. Postpartum screening rates for diabetes are only about 50%, highlighting the need for improved follow-up care. Evidence-based interventions, including behavioral interventions focusing on diet and exercise, as well as pharmacotherapy like metformin, can help reduce the risk of type 2 diabetes. However, more research is needed on the safety and effectiveness of these interventions during lactation. Primary care physicians play a crucial role in screening for GDM during pregnancy and providing postpartum care to mitigate long-term cardiometabolic risks.