Considerations in the Management of Gestational Diabetes Mellitus: “You Are What Your Mother Ate!”

It is clear that there remains a global crisis in the development and consequences of chronic diseases such as obesity and type 2 diabetes. These conditions lead to complications that increase morbidity and mortality, such as heart disease, stroke, amputations, and kidney disease. We have learned a great deal about the pathogenesis of these disorders and also about both treatment and preventive interventions. Clearly, there remains considerable progress to be made specifically in addressing these conditions and, more importantly, in preventing these conditions in resource-poor areas.Over the recent past, there has been a startling new set of observations on the genesis of these conditions. There are data that certain processes observed in utero and in early childhood can certainly affect the risk of developing chronic diseases at a later age (1–3). This clearly provides a great opportunity to interdict on these pathophysiological processes when they may have the greatest effect. As such, there is a growing interest in learning more about epigenetic phenomena and how these events that can be observed in prenatal and early postnatal life can modulate the risk for the development of chronic diseases (i.e., obesity and type 2 diabetes) in adolescence and early adulthood.In this regard, it is of great interest to study a metabolic environment that may play a great role in later issues affecting human health. Specifically, given the importance of the maternal environment and the potential impact that gestational diabetes mellitus (GDM) may have, we devote a special section in this issue of Diabetes Care to articles related to GDM. The topics covered in this special section include evaluation of dietary factors, intervention strategies to prevent and treat GDM, and appropriate screening and diagnostic testing. As is the case with most topics, new data are presented that address specific …