Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance with onset or first recognition during pregnancy. It is characterized by impaired insulin secretion and action. GDM complicates about 1-3% of all pregnancies in the Western world. In Sweden the diagnosis of GDM is based on a 75 g OGTT and defined as a 2-hour capillary plasma glucose concentration of at least 10 mmol/l. According to these criteria approximately 1.9 % of pregnant women in Sweden develop GDM. Although most women with GDM revert to normal after delivery, impaired glucose tolerance (IGT) and/or diabetes, develop in about 50% within 10 years postpartum.
Women with GDM often have a history of maternal diabetes, which suggest a genetic component for the disease. Moreover the offspring of women with abnormal glucose tolerance during pregnancy are at higher risk of developing insulin resistance, obesity and diabetes at an early age.
The aim of the study is:
- To determine incidence rate of diabetes in all women in Skåne with GDM, impaired glucose tolerance or normal glucose tolerance during pregnancy (inclusion period three years) by means of OGTTs 1-2 and 5 years postpartum and to characterize these women with regard to anthropometric variables, parameters of insulin secretion and sensitivity, autoimmune and genetic markers.
- To study whether autoimmunity and variation in genes affecting insulin secretion and action contribute to the development of GDM and future diabetes.
- To study whether GDM pathogenesis differs between women with Scandinavian and non-European ethnic background.