Prediction and Prevention of Type 2 Diabetes in Women with a History of GDM.

PURPOSE OF THE REVIEW: Women with a history of gestational diabetes mellitus (GDM) have an alarmingly high risk of developing type 2 diabetes (T2D); yet, mechanisms underlying this progression are largely unknown.

RECENT FINDINGS: Clinical characteristics of a GDM pregnancy and postpartum metabolomics may contribute to risk prediction of T2D to identify those women at highest risk of progression and need for intervention. Evidence for effective postpartum lifestyle interventions from observational studies include adherence to a healthy dietary pattern, increasing physical activity, and maintaining a healthy body weight. Larger clinical trials with greater participant engagement are warranted to confirm the effectiveness of lifestyle interventions in women with recent GDM. Research is needed to refine prediction models of T2D after GDM, and to determine the most effective strategies to delay or prevent T2D onset. Incorporating novel biomarkers in the postpartum period, such as metabolomics, could offer a powerful approach.