Home›Diabetes & Endocrinology› Untreated glucose intolerance in pregnancy linked to postpartum metabolic dysfunction similar to treated GDM
Untreated glucose intolerance in pregnancy linked to postpartum metabolic dysfunction similar to treated GDMGestational diabetes impacts metabolic health one year after pregnancy
The Journal of clinical endocrinology and metabolismPublished June 17, 2026Study authors: Scifres Christina M, Sinha Arunabh, Orris Steve, Costacou Tina, Lalama Christina, Abebe Kaleab Z, Ca…PubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider postpartum metabolic screening for all women with gestational glucose intolerance, not just those with treated GDM.
This planned 12-month postpartum follow-up of the Gestational Diabetes Diagnostic Methods (GDM2) trial assessed metabolic characteristics and β-cell function in 407 pregnant individuals with varying levels of gestational glucose intolerance. Participants were categorized as having untreated glucose intolerance (by CC criteria), treated GDM, or normal glucose tolerance.
At 12 months postpartum, 49 (12%) had untreated glucose intolerance and 53 (13%) had treated GDM. Both groups showed significant differences in insulin sensitivity, β-cell function, dyslipidemia, leptin, and adiponectin compared to individuals with normal glucose tolerance. Specific effect sizes were not reported.
Safety outcomes were not reported. The study design was a planned follow-up of an RCT, but the comparison is observational, limiting causal inference. Key limitations include lack of effect sizes and absence of adverse event data.
Clinically, these findings suggest that untreated glucose intolerance in pregnancy carries similar postpartum metabolic risks as treated GDM, highlighting the need for postpartum metabolic assessment in all women with gestational glucose intolerance.
How this fits prior evidence
This finding extends prior coverage on gestational diabetes and postpartum metabolic risk. While prior reports focused on pharmacologic interventions (e.g., once-weekly insulin, SGLT2 inhibitors) or novel biomarkers (transcriptomic genes), this study addresses a gap by comparing untreated glucose intolerance to treated GDM. It confirms that even mild gestational glucose intolerance is associated with persistent metabolic dysfunction, similar to treated GDM, reinforcing the importance of postpartum screening.
Managing blood sugar during pregnancy is about more than just the nine months of gestation. It can set the stage for how the body handles energy and insulin long after the baby is born. A study followed 407 pregnant individuals to see how their bodies functioned one year after giving birth.
The researchers looked at women who had gestational diabetes (GDM) and those with untreated glucose intolerance. They found that both groups showed significant differences in insulin sensitivity and cell function compared to people with normal blood sugar levels. Specifically, the study found that 12% of the group had untreated glucose intolerance while 13% had treated GDM.
Even if a person's high blood sugar during pregnancy was not treated, their body still showed signs of metabolic struggle one year later. These issues included problems with how cells respond to insulin and changes in fat levels. While the study shows these conditions are similar for both groups, it is important to talk to a doctor about specific health goals after pregnancy.
What this means for you:
Both treated and untreated high blood sugar during pregnancy lead to similar metabolic issues one year later.
Common questions
How does gestational diabetes affect health after pregnancy?
The study found that individuals with gestational diabetes or untreated glucose intolerance showed significant differences in insulin sensitivity and cell function one year after giving birth. These metabolic issues were similar for both groups compared to people with normal blood sugar levels.
What did the study find about untreated glucose intolerance?
The study found that 49 out of 407 individuals (12%) had untreated glucose intolerance. These individuals showed metabolic abnormalities and impaired cell function one year postpartum, similar to those who were treated for gestational diabetes.
How many people were involved in this research?
The study included 407 pregnant individuals with varying levels of glucose intolerance. This group was followed for 12 months after giving birth to check their metabolic health and how well their cells produced insulin.
CONTEXT: Gestational diabetes mellitus (GDM) is associated with long-term risk for type 2 diabetes.
OBJECTIVE: We evaluated metabolic characteristics and β-cell function during pregnancy and at 12 months postpartum among individuals with varying levels of gestational glucose intolerance.
METHODS: This was a planned 12-month postpartum follow-up to the Gestational Diabetes Diagnostic Methods (GDM2) trial, which randomized pregnant individuals to GDM testing using either the International Association of Diabetes and Pregnancy Study Group (IADPSG) or Carpenter-Coustan (CC) criteria. All GDM2 participants with treated GDM (diagnosed by either CC or IADPSG), those with untreated glucose intolerance in the CC arm, and half of the participants with normal glucose tolerance were invited for 12-month follow-up. Glucose values, Stumvoll and Matsuda Indices to evaluate insulin sensitivity and resistance, the disposition index (DI), lipids, leptin, and adiponectin were assessed at 12 months postpartum. .
RESULTS: Of the 407 individuals seen at 12 months, 49 (12%) had untreated glucose intolerance and 53 (13%) had treated GDM (CC and IADPSG). Both during pregnancy and at 12 months postpartum, there were significant differences in insulin sensitivity, β-cell function, dyslipidemia, and alterations in leptin and adiponectin among individuals with both untreated glucose tolerance and treated GDM when compared with those with normal glucose testing.
CONCLUSION: Individuals with untreated glucose intolerance in pregnancy by the CC criteria have impaired β-cell function and significant metabolic abnormalities at 12 months postpartum similar to individuals with treated GDM, highlighting the need for ongoing preventive attention in this population to prevent type 2 diabetes later in life.
