Glucose metabolism before and after gestational diabetes mellitus
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospitaly, lecture room 3
Topic of the dissertation
Glucose metabolism before and after gestational diabetes mellitus
Doctoral candidate
Licentiate of Medicine (MD) Anna-Maaria Auvinen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine
Subject of study
Obstetrics and Gynecology
Opponent
Professor Hannele Laivuori, University of Tampere
Custos
Professor Juha Tapanainen, University of Helsinki
Glucose metabolism before and after gestational diabetes mellitus
More than half of women who develop gestational diabetes (GDM) later develop type 2 diabetes (T2DM). Additionally, approximately 6% are diagnosed with type 1 diabetes (T1DM) within seven years after giving birth. The most significant individual predictor of later diabetes in the study was insulin treatment during pregnancy. Certain autoantibodies, particularly ICA and GADA, also predicted the development of T1DM. The study further found that women who develop GDM already exhibit higher insulin resistance before pregnancy and, later in life, more central obesity compared to healthy controls.
GDM is a glucose metabolism disorder first diagnosed during pregnancy. The increasing prevalence of both GDM and T2DM is closely linked to rising obesity rates. GDM significantly increases the risk of developing diabetes—especially T2DM—as well as other metabolic conditions such as high blood pressure, abnormal cholesterol levels, and cardiovascular disease.
This thesis is based on data from a case-control study and the Northern Finland Birth Cohort 1966. In the case-control study, women with GDM were followed for 23 years. During this period, 50.4% developed T2DM. T1DM was diagnosed in 5.7% of participants, all within seven years postpartum. Insulin treatment during pregnancy, which also reflects the severity of GDM, was the strongest predictor for both types of diabetes. In addition, results from the oral glucose tolerance test and maternal age during pregnancy were associated with an increased risk of later diabetes. ICA and GADA autoantibodies measured during pregnancy also proved to be effective predictors of T1DM.
In the Northern Finland Birth Cohort 1966, women who developed GDM were found to have higher insulin resistance even before the onset of GDM. At age 46, they also showed more central obesity compared to healthy controls.
This research demonstrates that GDM is not merely a temporary condition of pregnancy but a lifelong risk factor, particularly for T2DM. Risk factors may already be detectable before pregnancy. Therefore, it is essential that both affected women and healthcare professionals recognize these risks early and implement lifestyle interventions to help prevent diabetes and its complications.
GDM is a glucose metabolism disorder first diagnosed during pregnancy. The increasing prevalence of both GDM and T2DM is closely linked to rising obesity rates. GDM significantly increases the risk of developing diabetes—especially T2DM—as well as other metabolic conditions such as high blood pressure, abnormal cholesterol levels, and cardiovascular disease.
This thesis is based on data from a case-control study and the Northern Finland Birth Cohort 1966. In the case-control study, women with GDM were followed for 23 years. During this period, 50.4% developed T2DM. T1DM was diagnosed in 5.7% of participants, all within seven years postpartum. Insulin treatment during pregnancy, which also reflects the severity of GDM, was the strongest predictor for both types of diabetes. In addition, results from the oral glucose tolerance test and maternal age during pregnancy were associated with an increased risk of later diabetes. ICA and GADA autoantibodies measured during pregnancy also proved to be effective predictors of T1DM.
In the Northern Finland Birth Cohort 1966, women who developed GDM were found to have higher insulin resistance even before the onset of GDM. At age 46, they also showed more central obesity compared to healthy controls.
This research demonstrates that GDM is not merely a temporary condition of pregnancy but a lifelong risk factor, particularly for T2DM. Risk factors may already be detectable before pregnancy. Therefore, it is essential that both affected women and healthcare professionals recognize these risks early and implement lifestyle interventions to help prevent diabetes and its complications.
Last updated: 20.5.2025