Review

. 2023 Jan;160 Suppl 1(Suppl 1):56-67.

doi: 10.1002/ijgo.14537.

Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice

Sumaiya Adam^{1

2}, Harold David McIntyre³, Kit Ying Tsoi⁴, Anil Kapur⁵, Ronald C Ma^{4

6}, Stephanie Dias⁷, Pius Okong⁸, Moshe Hod^{9

10}, Liona C Poon¹¹, Graeme N Smith¹², Lina Bergman^{13

14

15}, Esraa Algurjia^{16

17}, Patrick O'Brien¹⁸, Virna P Medina¹⁹, Cynthia V Maxwell²⁰, Lesley Regan²¹, Mary L Rosser²², Bo Jacobsson^{23

24}, Mark A Hanson^{25

26}, Sharleen L O'Reilly^{27

28}, Fionnuala M McAuliffe²⁷; FIGO Committee on the Impact of Pregnancy on Long-term Health and the FIGO Division of Maternal and Newborn Health

Affiliations

¹ Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
² Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
³ Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia.
⁴ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁵ World Diabetes Foundation, Denmark.
⁶ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.
⁷ Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Cape Town, South Africa.
⁸ Department of Obstetrics and Gynecology, St Francis Hospital Nsambya, Kampala City, Uganda.
⁹ Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
¹⁰ Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹¹ Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
¹² Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
¹³ Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁴ Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
¹⁵ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
¹⁶ The World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.
¹⁷ Elwya Maternity Hospital, Baghdad, Iraq.
¹⁸ Institute for Women's Health, University College London, London, UK.
¹⁹ Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia.
²⁰ Maternal Fetal Medicine, Sinai Health and Women's College Hospital University of Toronto, Ontario, Canada.
²¹ Imperial College London, London, UK.
²² Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.
²³ Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.
²⁴ Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway.
²⁵ Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.
²⁶ NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.
²⁷ UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
²⁸ School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.

PMID: 36635082
PMCID: PMC10107137
DOI: 10.1002/ijgo.14537

Review

Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice

Sumaiya Adam et al. Int J Gynaecol Obstet. 2023 Jan.

. 2023 Jan;160 Suppl 1(Suppl 1):56-67.

doi: 10.1002/ijgo.14537.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
² Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
³ Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia.
⁴ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁵ World Diabetes Foundation, Denmark.
⁶ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.
⁷ Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Cape Town, South Africa.
⁸ Department of Obstetrics and Gynecology, St Francis Hospital Nsambya, Kampala City, Uganda.
⁹ Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
¹⁰ Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹¹ Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
¹² Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
¹³ Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁴ Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
¹⁵ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
¹⁶ The World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.
¹⁷ Elwya Maternity Hospital, Baghdad, Iraq.
¹⁸ Institute for Women's Health, University College London, London, UK.
¹⁹ Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia.
²⁰ Maternal Fetal Medicine, Sinai Health and Women's College Hospital University of Toronto, Ontario, Canada.
²¹ Imperial College London, London, UK.
²² Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.
²³ Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.
²⁴ Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway.
²⁵ Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.
²⁶ NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.
²⁷ UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
²⁸ School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.

PMID: 36635082
PMCID: PMC10107137
DOI: 10.1002/ijgo.14537

Abstract

Gestational diabetes (GDM) impacts approximately 17 million pregnancies worldwide. Women with a history of GDM have an 8-10-fold higher risk of developing type 2 diabetes and a 2-fold higher risk of developing cardiovascular disease (CVD) compared with women without prior GDM. Although it is possible to prevent and/or delay progression of GDM to type 2 diabetes, this is not widely undertaken. Considering the increasing global rates of type 2 diabetes and CVD in women, it is essential to utilize pregnancy as an opportunity to identify women at risk and initiate preventive intervention. This article reviews existing clinical guidelines for postpartum identification and management of women with previous GDM and identifies key recommendations for the prevention and/or delayed progression to type 2 diabetes for global clinical practice.

Keywords: cardiometabolic; diabetes; gestational diabetes; health systems; hyperglycemia; prevention.

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Conflict of interest statement

Harold David McIntyre reports honoraria for lectures from Phillips Health Care, Mead Johnson (China), and Diabetes Ireland. Ronald Ma reports research support from AstraZeneca, Bayer, Novo Nordisk, Pfizer, and Tricida Inc. Lina Bergman reports research funds from Thermo Fischer, Roche, and Perkin Elmer and payment from Homburg and Partner. Cynthia Maxwell reports grants from the Canadian Institutes for Health Research and the Crohns and Colitis Foundation of Canada. Sharleen O'Reilly reports research grants from the European Commission Horizon 2020, National Health and Medical Research Council of Australia, Health Research Board Ireland, Al Qasimi Foundation, and University of Sharjah. Other authors have no conflicts of interests to declare.

Figures

**FIGURE 1**
Factors influencing attendance at postpartum follow‐up for glucose testing after GDM. Reproduced from Dennison et al. under CC BY 4.0 license (http://creativecommons.org/licenses/by/4.0/).

**FIGURE 2**
The healthcare system that cares for women with gestational diabetes. Reproduced from Sacks et al. under CC BY‐NC 4.0 license (http://creativecommons.org/licenses/by‐nc/4.0/).

**FIGURE 3**
Information to be shared to promote behavior change.

**FIGURE 4**
Current challenges and research gaps in gestational diabetes mellitus. Reproduced from Chu et al. under CC BY‐NC‐ND license (https://creativecommons.org/licenses/by‐nc‐nd/4.0/).

See this image and copyright information in PMC

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References

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1. Hod M, Kapur A, Sacks DA, et al. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynecol Obstet. 2015;131(Suppl 3):S173‐S211. - PubMed
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Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice

Affiliations

Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice

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