Journal Article Review Ahead of print
PubMed: 41891941 DOI: 10.1113/JP290546
Reframing gestational diabetes mellitus through two new paradigms: Early detection and lifelong intergenerational follow-up.
J Physiol
Authors: Marilza Vieira Cunha Rudge, Claudia Garcia Magalhães, Danielle Cristina Honório França, Roberto Araujo Costa, Katherin Silva, Iracema Mattos Paranhos Calderon, Luis Sobrevia
Affiliations
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, Department of Obstetrics, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
- Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville, Spain.
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, Queensland, Australia.
Abstract
Gestational diabetes mellitus (GDM) has traditionally been regarded as a transient metabolic disorder limited to pregnancy, with management directed primarily towards reducing obstetric and perinatal complications. Yet a growing body of evidence over the past two decades compels a fundamental redefinition. Two emerging paradigms expand the physiological and clinical understanding of GDM. The first recognizes early-onset GDM (e-GDM), diagnosed in the first trimester, as a severe metabolic phenotype reflecting pre-existing dysfunction. The second reinterprets GDM as a lifelong, intergenerational condition, a sentinel event marking heightened risk for chronic cardiometabolic disease in both mother and offspring. Together, these frameworks demand a transition from short-term obstetric management to long-term preventive physiology, integrating early diagnosis, mechanistic understanding, and intergenerational care.
MeSH
Diabetes Mellitus, Diabetes, Gestational, Physiology, Placenta, Endothelium