Weight change and risk of cardiovascular disease among adults with type 2 diabetes: more than 14 years of follow-up in the Tehran Lipid and Glucose Study

Abstract Background To examine the impact of weight change on incident cardiovascular disease and coronary heart disease (CVD/CHD) among an Iranian population with type 2 diabetes mellitus (T2DM). Methods The study population included 763 participants with T2DM aged ≥ 30 years without a history of CVD and cancer at baseline. Two weight measurements done at baseline and about 3 years later. Based on their weight change, they categorized into: > 5% loss, 3–5% loss, stable (± < 3%), 3–5% gain, > 5% gain. Participants were then followed for incident CVD/CHD annually up to 20 March 2018. Multivariable Cox proportional hazard models, adjusted for age, sex, body mass index, educational level, current smoking, glucose-lowering drug use, family history of CVD, hypertension, hypercholesterolemia, chronic kidney disease, and fasting plasma glucose (FPG) were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for incident CVD/CHD, considering stable weight as reference. Results After the weight change measurement, during a median follow-up of 14.4 years, 258 CVD and 214 CHD occurred. Over 5% weight gain was associated with reduced risks of CVD and CHD development by the HRs of 0.70 [95% CI 0.48–1.01; P-value: 0.058] and 0.61 [0.40–0.93], respectively, in multivariable analysis. After further adjustment for FPG change, the HRs of weight gain > 5% were attenuated to 0.75 [0.51–1.10; P-value: 0.138] and 0.66 [043–1.01; P-value: 0.053] for incident CVD and CHD, respectively. The effect of weight loss > 5% was in opposite direction among those older versus younger than 60 years; with suggestive increased risk (not statistically significant) of incident CHD/CVD for the older group. Moreover, weight gain > 5% significantly reduced the risk of CHD only among those older than 60 years (P-value for interaction < 0.2). Furthermore, weight gain > 5% had an association with lower risk of CVD and CHD among sulfonylurea users (0.56 [0.32–0.98] for CVD and 0.54 [0.29–0.99] for CHD). Conclusions Our results with a long-term follow-up showed that weight gain > 5% was associated with better CVD/CHD outcomes among Iranian participants with T2DM, especially older ones. Moreover, we did not find an unfavorable impact on incident CVD/CHD for sulfonylurea-induced weight gain.

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Vitamin D status and risk of type 2 diabetes in the Norwegian HUNT cohort study: does family history or genetic predisposition modify the association?

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001948 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001948

Author(s):

Marion Denos ◽

Xiao-Mei Mai ◽

Bjørn Olav Åsvold ◽

Elin Pettersen Sørgjerd ◽

Yue Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Family History ◽

Genetic Predisposition ◽

Effect Modification ◽

P Value ◽

Family History Of Diabetes ◽

Increased Risk ◽

History Of

IntroductionWe sought to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and the risk of type 2 diabetes mellitus (T2DM) in adults who participated in the Trøndelag Health Study (HUNT), and the possible effect modification by family history and genetic predisposition.Research design and methodsThis prospective study included 3574 diabetes-free adults at baseline who participated in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys. Serum 25(OH)D levels were determined at baseline and classified as <50 and ≥50 nmol/L. Family history of diabetes was defined as self-reported diabetes among parents and siblings. A Polygenic Risk Score (PRS) for T2DM based on 166 single-nucleotide polymorphisms was generated. Incident T2DM was defined by self-report and/or non-fasting glucose levels greater than 11 mmol/L and serum glutamic acid decarboxylase antibody level of <0.08 antibody index at the follow-up. Multivariable logistic regression models were applied to calculate adjusted ORs with 95% CIs. Effect modification by family history or PRS was assessed by likelihood ratio test (LRT).ResultsOver 11 years of follow-up, 92 (2.6%) participants developed T2DM. A higher risk of incident T2DM was observed in participants with serum 25(OH)D level of<50 nmol/L compared with those of ≥50 nmol/L (OR 1.72, 95% CI 1.03 to 2.86). Level of 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in adults without family history of diabetes (OR 3.87, 95% CI 1.62 to 9.24) but not in those with a family history (OR 0.72, 95% CI 0.32 to 1.62, p value for LRT=0.003). There was no effect modification by PRS (p value for LRT>0.23).ConclusionSerum 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in Norwegian adults. The inverse association was modified by family history of diabetes but not by genetic predisposition to T2DM.

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Depression-related weight change and incident diabetes in a community sample

Scientific Reports ◽

10.1038/s41598-021-92963-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eva Graham ◽

Tristan Watson ◽

Sonya S. Deschênes ◽

Kristian B. Filion ◽

Mélanie Henderson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Short Form ◽

Community Sample ◽

Overweight And Obesity ◽

Community Dwelling ◽

Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

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Impact of taxanes on weight gain during neoadjuvant chemotherapy (Ctx) for breast cancer (BC)

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10606 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10606-10606

Author(s):

M. E. Melisko ◽

C. A. Millerick ◽

P. Maniar ◽

D. Moore ◽

M. Rosenwein ◽

...

Keyword(s):

Weight Gain ◽

Weight Change ◽

Cox Regression ◽

Menopausal Status ◽

Baseline Body Mass Index ◽

Risk Of Recurrence ◽

Increased Risk ◽

Taxane Chemotherapy ◽

The Impact

10606 Background: Weight gain after the diagnosis of BC has been associated with increased risk of recurrence and mortality. Previous studies have documented weight gain after cyclophosphamide, methotrexate, and 5-fluoruracil (CMF) and adriamycin and cyclophosphamide (AC) chemotherapy, but the impact of taxane chemotherapy has not been described. Methods: We reviewed the charts of 119 patients (pts) who completed neoadjuvant Ctx between 1997–2005. Age, baseline body mass index (BMI), tumor size, nodal status, hormone receptor status, menopausal status, co-morbid illnesses and anti-depressant use were collected. Weight was recorded at each Ctx visit and at follow-up visits for two years. Results: 22 pts received AC only. 97 pts received AC followed by a taxane - 58 docetaxel (D), 39 paclitaxel (P). Median f/u time was 26.3 months. 66/119 (55%) of pts gained weight during Ctx, with a median change of + 1 pound (range -28 to +19.5 pounds) at the end of Ctx. 49/119 (41%) of pts gained weight during AC and 76/97 (78%) of pts gained weight during the taxane. Mean weight change after AC was -1.8 pounds compared to +3.2 pounds after the taxane (p < 0.001). Age, baseline BMI, and menopausal status prior to Ctx did not predict weight gain. There was no difference in weight gain between pts who received D vs. P (p = 0.19). 8/22 (36%) patients who received AC alone recurred, and 13/95 (14%) who received both AC and T recurred; however this was not statistically significant (p = 0.23). Total weight change during neoadjuvant Ctx did not predict recurrence; however weight gain during the AC portion was associated with a higher risk of recurrence when adjusted for weight gain during taxane Ctx (p = 0.035, Cox regression). Each one pound gained was associated with an 11% increase in risk of recurrence. Conclusions: Weight gain is common during neoadjuvant Ctx for BC, particulary during treatment with taxanes. Further follow up is required to establish if weight gain is maintained over time and to determine the impact of weight change on BC outcomes and health. No significant financial relationships to disclose.

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Pharmacogenetics of sulfonylurea-induced hypoglycemia in Type 2 diabetes patients: the SUCLINGEN study

Pharmacogenomics ◽

10.2217/pgs-2021-0059 ◽

2021 ◽

Author(s):

Navin Kumar Loganadan ◽

Hasniza Zaman Huri ◽

Shireene Ratna Vethakkan ◽

Zanariah Hussein

Keyword(s):

Type 2 Diabetes ◽

Odds Ratio ◽

Gene Polymorphisms ◽

Prospective Observational Study ◽

Severe Hypoglycemia ◽

Prior History ◽

Increased Risk ◽

History Of

Aim: This study investigated the incidence of sulfonylurea-induced hypoglycemia and its predictors in Type 2 diabetes (T2D) patients. Patients & methods: In this prospective, observational study, T2D patients on maximal sulfonylurea-metformin therapy >1 year were enrolled. Hypoglycemia was defined as having symptoms or a blood glucose level <3.9 mmol/l. Results: Of the 401 patients, 120 (29.9%) developed sulfonylurea-induced hypoglycemia during the 12-month follow-up. The ABCC8 rs757110, KCNJ11 rs5219, CDKAL1 rs7756992 and KCNQ1 rs2237892 gene polymorphisms were not associated with sulfonylurea-induced hypoglycemia (p > 0.05). Prior history of hypoglycemia admission (odds ratio = 16.44; 95% CI: 1.74–154.33, p = 0.014) independently predicted its risk. Conclusion: Sulfonylurea-treated T2D patients who experienced severe hypoglycemia are at increased risk of future hypoglycemia episodes.

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Abstract P031: Weight Changes and Their Predictors Among 11,140 Patients With Type 2 Diabetes in The Advance Trial

Circulation ◽

10.1161/circ.125.suppl_10.ap031 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Susan van Dieren ◽

Andre Pascal Kengne ◽

John Chalmers ◽

Joline Beulens ◽

Yvonne van der Schouw ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Weight Change ◽

Glucose Control ◽

Diabetes Research ◽

Mixed Effect ◽

Glucose Lowering ◽

The Mean

Background/Aim: To determine the baseline characteristics and glucose lowering therapies associated with weight change among subjects with type 2 diabetes. Methods: 11,140 participants in the ADVANCE trial, were randomly assigned to an intensive (aiming for an HbA 1c ≤ 6.5%) or a standard blood glucose control strategy. Weight was measured at baseline and every 6 months over a median follow-up of 5 years. Multivariable linear regression and linear mixed effect models were used to examine predictors of weight change. Results: The mean difference in weight between the intensive and standard glucose control arm during follow-up was 0.75 kg (95% CI: 0.56 to 0.94), p-value<0.001. The mean weight decreased by 0.70 kg (95% CI: 0.53 to 0.87), p <0.001 by the end of follow-up in the standard arm but remained stable in the intensive arm, with a non-significant gain of 0.16 kg (95% CI: -0.02 to 0.34), p=0.075. Baseline factors associated with weight gain were younger age, higher HbA 1c , Caucasian ethnicity and number of glucose lowering medications. Treatment combinations including insulin [3.20 kg (95% CI: 2.90 to 3.50)] and thiazolidinediones [3.05 kg (95% CI: 2.68 to 3.42)] were associated with the greatest weight gain whilst treatment combinations including sulphonylureas were associated with less weight gain [0.71 kg (95%CI: 0.39 to 1.03)] (Figure 1). Conclusion: Intensive glucose control regimens are not necessarily associated with substantial weight gain. Patient characteristic associated with weight change were age, ethnicity, smoking and HbA1c. The main treatment strategies predicting weight gain were the use of insulin and thiazolidinediones. Acknowledgements: This research was supported by a program grant from the National Health and Medical Research Council of Australia, the Center for Translational Molecular Medicine (CTMM) and the Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney Foundation (PREDICCt).

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Abstract 07: Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes in Later Life

Circulation ◽

10.1161/circ.135.suppl_1.07 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Yan Zheng ◽

JoAnn Manson ◽

Changzheng Yuan ◽

Matthew Liang ◽

Francine Grodstein ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Weight Gain ◽

Health Outcomes ◽

Healthy Aging ◽

Cataract Extraction ◽

Middle Adulthood ◽

Incident Cases

Background: The association of weight gain from early to middle adulthood with a wide range of health outcomes later in life has not been systematically examined. Methods: We included 93,873 women from the Nurses’ Health Study and 25,374 men from the Health Professionals Follow-up Study who recalled weight at early adulthood (18 years in women, 21 years in men) and reported current weight in middle adulthood (55 years). Beginning from 55 years old, we prospectively followed them for incident cases of type 2 diabetes, hypertension, cardiovascular disease, cancer, three other medical conditions, and all-cause mortality. Among 51,185 women and 17,694 men who were at least 64 years of age in 2010, we also considered “healthy aging”, defined as no diagnosis of 11 major chronic diseases and no major cognitive impairment, physical impairment, or mental health limitations. Results: On average, female participants gained 12.55 kg (interquartile range: 14.36 kg) of body weight and males gained 9.68 kg (interquartile range: 11.19 kg) from early to middle adulthood. During a median follow-up of 18 years in women and 14 years in men, we documented 9360 incident cases of type 2 diabetes, 37,298 of hypertension, 9220 of cardiovascular disease, 20,222 of cancer (including 9458 of obesity-related cancers), 7438 of symptomatic cholelithiasis, 2702 of severe osteoarthritis, 31,960 of cataract extraction, and 27,250 deaths. In multivariate models, compared to those maintained stable weight (weight change <2.5kg), participants who gained 20+ kg had increased risks of: diabetes (hazard ratio [HR, 95%CI], 10.93[9.65–12.39] in women, 8.19[6.41–10.46] in men), hypertension (2.24[2.15–2.34] in women, 2.11[1.91–2.33] in men), cardiovascular disease (1.87[1.72–2.04] in women, 1.72[1.40–2.11] in men), obesity-related cancers (1.53[1.41–1.66] in women, 1.27[0.95–1.69] in men), and mortality (1.43[1.37–1.50] in women, 1.34[1.18–1.51] in men); they had decreased odds of healthy aging (odds ratio [OR, 95%CI], 0.36[0.32–0.40] in women and 0.50[0.43–0.57] in men). In a meta-analysis combing both sexes, the increase in risk associated with each 10 kg weight gain was 71% for type 2 diabetes, 27% for hypertension, 17% for cardiovascular disease, 31% for symptomatic cholelithiasis, 15% for obesity-related cancers, 9% for severe osteoarthritis, 5% for cataract extraction, and 9% for mortality; for the same weight gain the odds of healthy aging was 28% lower. Conclusions: Our data provide strong evidence that weight gain from early to middle adulthood is associated with substantially increased risk of major chronic diseases and mortality, and overall decreased odds of aging with good health and well-being among women and men.

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Timed Bromocriptine-QR Therapy Reduces Progression of Cardiovascular Disease and Dysglycemia in Subjects with Well-Controlled Type 2 Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2015/157698 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 19

Author(s):

Bindu Chamarthi ◽

J. Michael Gaziano ◽

Lawrence Blonde ◽

Aaron Vinik ◽

Richard E. Scranton ◽

...

Keyword(s):

Metabolic Disease ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Glycemic Control ◽

Dopamine D2 Receptor ◽

Double Blind Study ◽

Good Glycemic Control ◽

Increased Risk ◽

The Impact

Background.Type 2 diabetes (T2DM) patients, including those in good glycemic control, have an increased risk of cardiovascular disease (CVD). Maintaining good glycemic control may reduce long-term CVD risk. However, other risk factors such as elevated vascular sympathetic tone and/or endothelial dysfunction may be stronger potentiators of CVD. This study evaluated the impact of bromocriptine-QR, a sympatholytic dopamine D2 receptor agonist, on progression of metabolic disease and CVD in T2DM subjects in good glycemic control (HbA1c ≤7.0%).Methods.1834 subjects (1219 bromocriptine-QR; 615 placebo) with baseline HbA1c ≤7.0% derived from the Cycloset Safety Trial (this trial is registered with ClinicalTrials.gov Identifier:NCT00377676), a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were evaluated. Treatment impact upon a prespecified composite CVD endpoint (first myocardial infarction, stroke, coronary revascularization, or hospitalization for angina/congestive heart failure) and the odds of losing glycemic control (HbA1c >7.0% after 52 weeks of therapy) were determined.Results.Bromocriptine-QR reduced the CVD endpoint by 48% (intention-to-treat; HR: 0.52 [0.28−0.98]) and 52% (on-treatment analysis; HR: 0.48 [0.24−0.95]). Bromocriptine-QR also reduced the odds of both losing glycemic control (OR: 0.63 (0.47−0.85),p=0.002) and requiring treatment intensification to maintain HbA1c ≤7.0% (OR: 0.46 (0.31−0.69),p=0.0002).Conclusions.Bromocriptine-QR therapy slowed the progression of CVD and metabolic disease in T2DM subjects in good glycemic control.

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Long-Term Weight Change and Glycemic Control in Patients With Type 2 Diabetes Mellitus and Treated vs. Untreated Sleep-Disordered Breathing—Analysis From the DIAbetes COhoRtE

Frontiers in Neurology ◽

10.3389/fneur.2021.745049 ◽

2021 ◽

Vol 12 ◽

Author(s):

Louisa Schaller ◽

Michael Arzt ◽

Bettina Jung ◽

Carsten A. Böger ◽

Iris M. Heid ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Weight Gain ◽

Weight Change ◽

Sleep Disordered Breathing ◽

Observation Period

Hypothesis: Positive airway pressure (PAP) is the standard treatment for sleep-disordered breathing (SDB), a prevalent condition in patients with type 2 diabetes mellitus (DM2). Recent studies showed that short-term PAP treatment may cause weight gain. However, long-term data for patients with DM2 are scarce. Therefore, the aim of the present analysis was to assess changes in weight and glycemic control in patients with DM2 and treated vs. untreated SDB.Methods: The DIAbetes COhoRtE (DIACORE) study is a prospective population-based cohort study in patients with DM2. At baseline, patients of the DIACORE-SDB sub-study were tested for SDB [defined as apnea-hypopnea-index (AHI) ≥ 15/h] using a two-channel ambulatory SDB-monitoring device. In this observational study, PAP treatment was initiated in a subgroup of patients with SDB (SDB PAP) within clinical routine between the baseline and first follow-up visit [median observation period of 2.3 (2.2; 2.4) years], whereas the other patients with SDB did not receive PAP (SDB untreated). At baseline and first follow-up visit, weight and HbA1c were assessed.Results: Of the 346 patients with SDB [mean age 68 years, 71% male, body-mass index (BMI) 31.9 kg/m2], 17% were in the SDB PAP and 83% in the SDB untreated group. Weight change within the observation period was similar in both groups (−0.2 and −0.9 kg; p = 0.322). The percentage of patients with severe weight gain (≥ 5 kg) within the observation period was significantly higher in the SDB PAP group compared to the SDB untreated group (15.0 vs. 5.6%; p = 0.011). Multivariable regression analysis, accounting for baseline HbA1c, insulin substitution, BMI, waist-to-hip ratio (WHR), physical activity, and AHI, showed that PAP treatment was significantly associated with a weight gain ≥ 5 kg [odds ratio (OR) = 3.497; 95% CI (1.343; 9.106); p = 0.010] and an increase in HbA1c [B = 2.410; 95% CI (0.118; 4.702); p = 0.039].Conclusion: Median weight change was similar in patients with SDB with and without PAP treatment. However, patients with DM2 and PAP treatment have an increased risk of severe long-term weight gain and an increase in HbA1c.Clinical Trial registration: DRKS00010498

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The Impact of Obesity on Adverse Cardiovascular Outcomes in the General Population and in patients with Type 2 Diabetes

Clinical medicine Endocrinology and diabetes ◽

10.4137/cmed.s3479 ◽

2009 ◽

Vol 2 ◽

pp. CMED.S3479 ◽

Cited By ~ 2

Author(s):

Jayne Palmer ◽

Anupama Kalsekar ◽

Kristina Boye ◽

Gordon Goodall

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

General Population ◽

Causal Link ◽

Cardiovascular Outcomes ◽

Asia Pacific ◽

Increased Risk ◽

General Populations ◽

The Impact

Objectives There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to cardiovascular disease) in the general population and in patients with type 2 diabetes. Methods A review of the medical literature published between 1988 and May 2008 was conducted using the PubMed, EMBASE, Cochrane and Center for Review and Dissemination databases. Studies longer than 12 months, with ≥500 adult subjects and published in English were included. Results In studies conducted in general populations there was an overall trend towards increased risk for adverse cardiovascular outcomes with increasing BMI. The nature and strength of this relationship varied according to the measurement used (e.g. BMI, waist circumference, waist-to-hip ratio) and the population studied, with notable differences observed in Asian/Asia-Pacific compared with European or North American-based studies. However, data from diabetes-specific populations are limited. Conclusions In general, the degree of being overweight or obese was associated with an elevated risk of adverse cardiovascular events and mortality. Although inextricable links exist between obesity, type 2 diabetes and cardiovascular disease in the general population, the extent to which findings can be extrapolated to a diabetes-specific population is limited.

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Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes

Current Pharmaceutical Design ◽

10.2174/1381612826666201106092423 ◽

2020 ◽

Vol 26 (43) ◽

pp. 5564-5572

Author(s):

Eleni Kousta ◽

Adamantia Kontogeorgi ◽

Stephen Robinson ◽

Desmond G. Johnston

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Increased Risk ◽

Metabolic Complication ◽

History Of

Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines on gestational diabetes have been impeded by the long-term controversies on its definition and screening strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has important long-term implications, including gestational diabetes recurrence, increased risk for developing type 2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines are briefly described and metabolic and cardiovascular long-term consequences of women with a history of gestational diabetes are summarized. A summary of our own St. Mary’s Hospital-UK Research series on long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic groups and 482 control women is also included. We found that approximately 2 years following delivery, 37% of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly, even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification of pre-pregnancy predictors and risk reduction before conception.

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