Follow-up Studies in Women with Gestational Diabetes mellitus. The Experience at Los Angeles Country/ University of Southern California Medical Center

Abstract

Gestational Diabetes Mellitus (GDM) has been defined as abnormal carbohydrate metabolism diagnosed for the first time during pregnancy; most women are asymptomatic and the diagnosis is made by the routine use of an oral glucose tolerance test (Freinkel, 1985). In most patients the fasting serum glucose is normal and remain so throughout pregnancy, but in about 10–15% fasting hyperglycemia is first diagnosed or develops with progression of gestation. In the majority of patients, carbohydrate metabolism returns to normal immediately following delivery. The incidence of GDM has been reported to be between 2–13% of all pregnancies (Mestman etal., 1971; Hadden, 1980; Sepe etal., 1985); it varies according to age, obesity, race, and family history of diabetes. A few studies available on the natural history of gestational diabetes indicate a high prevalence of overt diabetes mellitus years after the initial event (Mestman etal., 1972; Stowers etal., 1985; O’Sullivan, 1984; Metzger etal., 1985) (Table98). Furthermore, early studies in Pima Indians, suggest that the offspring of gestational diabetic mothers have a much higher incidence of diabetes than children of control mothers (Pettitt etal., 1985). In a previous publication (Mestman etal., 1972), we reported an incidence of 90% of abnormal oral Glucose Tolerance Test (GTT), in a group of 51 pregnant women with pregnancy fasting hyperglycemia up to 5 years after their pregnancies: the incidence of abnormal glucose tolerance test. was 45%. in those women with an abnormal pregnancy GTT but fasting euglycemia.