Preventing type 2 diabetes: public health implications for women with a history of gestational diabetes mellitus

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2008.06.031 Byline: Lucinda J. England (a), Patricia M. Dietz (a), Terry Njoroge (a), William M. Callaghan (a), Carol Bruce (a), Rebecca M. Buus (a), David F. Williamson (b) Keywords: diabetes gestational diabetes; prevention; postpartum screening Abstract: There is now strong evidence that lifestyle modification can prevent or delay the development of type 2 diabetes mellitus in high-risk individuals. Women with gestational diabetes mellitus are at increased risk for type 2 diabetes and so are candidates for prevention programs. We review literature on type 2 diabetes risk in women with gestational diabetes, examine current recommendations for postpartum and long-term follow-up, and summarize findings from a 2007 expert-panel meeting. We found data to support that women with gestational diabetes have an increase in risk of type 2 diabetes comparable in magnitude with that of individuals with impaired glucose tolerance and/or impaired fasting glucose and that prevention interventions likely are effective in this population. Current recommendations from leading organizations on follow-up of women after delivery are conflicting and compliance is poor. Clinicians and public health workers face numerous challenges in developing intervention strategies for this population. Translation research will be critical in addressing this important public health issue. Author Affiliation: (a) Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, GA (b) Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA Article History: Received 25 January 2008; Revised 8 April 2008; Accepted 11 June 2008 Article Note: (footnote) Cite this article as: England LJ, Dietz PM, Njoroge T, et al. Preventing type 2 diabetes: public health implications for women with a history of gestational diabetes mellitus. Am J Obstet Gynecol 2009;200:365.e1-365.e8. , Reprints not available from the authors., This study was supported by the Centers for Disease Control and Prevention, Atlanta, GA., The findings and conclusions of this report are those of the authors and do not necessarily represent those of the Centers for Disease Control and Prevention.