Gestational diabetes mellitus and life-course health

Gestational diabetes mellitus, traditionally defined as a disorder of hyperglycemia with a first onset or recognition during pregnancy, is a common condition that is complicated, costly, and controversial. Advances in understanding and awareness of gestational diabetes mellitus pathophysiology are resulting in an increasingly loud call for the application of personalized medicine approaches to both research on and clinical care of gestational diabetes mellitus. There is a shift away from viewing gestational diabetes mellitus as a condition to be diagnosed at 24 weeks of gestation and followed until 12 weeks postpartum to a condition of metabolic vulnerability that precedes pregnancy, persists after pregnancy, and requires a precise, life-course approach for health optimization facilitated by integrated, health-system-wide supports. This article reviews emerging areas of focus in gestational diabetes mellitus, with an emphasis on the relationship between the development of gestational diabetes mellitus and future health complications. The terms woman and women, mother, and maternal, are used in this paper to refer to all those, regardless of gender, who can become or have become pregnant.