The physiological changes of pregnancy mediate carbohydrate intolerance through pregnancy-specific hormones by increasing the peripheral resistance to insulin and production of glucose; these changes call for more production of insulin to maintain normal blood glucose levels during pregnancy.
Gestational diabetes (GDM) is one of the commonest metabolic disorders of pregnancy. It is defined as diabetes diagnosed during pregnancy that is clearly not pregestational in nature.
Long follow-up of women with history of GDM showed that they are at increased risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseases later in life.
The majority of women with GDM convert to normal glycemic status following delivery; however, they have increased risk of developing T2DM compared to women who did not have GDM. The reported rate of progression to T2DM varied considerably in different studies and is dependent on the period of follow-up, the diagnostic criteria for GDM, and the ethnicity of the studied population. Risk factors for progression to T2DM include family history of T2DM, need of insulin treatment, and obesity.
It has been proven that lifestyle modification and pharmacological interventions can prevent or delay progression to T2DM in women with history of GDM. Such interventions should be considered in the management of women with GDM especially that one in four Saudi women develops GDM during pregnancy and is among the high-risk population for developing T2DM.
Based on the American Diabetes Association (ADA) guidelines, different tests are equally effective for screening for impaired glucose tolerance (IGT) and diabetes including 75 oral glucose tolerance test (OGTT), fasting plasma glucose (FPG), or glycosylated hemoglobin A1C (HbA1c).
There is paucity of studies on the progression to T2DM among postpartum Saudi women. The objective of this study was to determine the prevalence and risk factors of glucose intolerance one year after delivery in women with GDM.