REVIEW article
Front. Physiol.
Sec. Developmental Physiology
GDM as a unique pathophysiological entity or a transitional pregnancy-induced glucose metabolism abnormality identifying primary diabetes types?
Vendula Bartáková 1
Eliška Ambrožová 2
Petr Žák 2
Katerina Kankova 1
1. Faculty of medicine, Department of Pathophysiology, Masaryk University, Brno, Czechia
2. Second Internal Clinic, Fakultni nemocnice Brno, Brno, Czechia
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Abstract
Gestational diabetes mellitus is defined as glucose intolerance first diagnosed during pregnancy; however, this diagnosis may actually represent a heterogeneous spectrum of primary diabetes phenotypes unmasked by the metabolic stress of pregnancy rather than a single pathophysiological entity. The current review aims to summarise available knowledge about the diabetes spectrum in pregnancy with particular focus on its pathophysiology, risk factors and postpartum destiny. Another aim was to find discuss possibilities for stratification of the women according to their immediate and future risks of postpartum persistence of glucose intolerance and its complications in later life. Specific objectives of the paper are: (1) to summarise data on physiological metabolic changes in pregnancy, (2) characterise the diabetes spectrum in pregnancy, (3) address the current state of the art in GDM diagnosis and management, (4) to summarize data on postnatal development and maturation of the infants who experienced GDM in utero and, finally (5) discuss possibilities to stratify GDM women according to the later risk for persistence of glucose intolerance after delivery.
Summary
Keywords
Diabetes in pregnancy, gestational diabetes mellitus, glucose metabolism abnormality, metabolic programming, postpartum diabetes risk
Received
30 December 2025
Accepted
18 February 2026
Copyright
© 2026 Bartáková, Ambrožová, Žák and Kankova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Vendula Bartáková
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