Degree Name

Doctor of Philosophy


Medical Research Unit


Subjects who have had gestational diabetes mellitus (GDM) are, by definition, not hyperglycemic after pregnancy and do not usually receive the benefit of detailed followup of their metabolic status. We examined the metabolic status of 65 women who had had a diagnosis of GDM and 65 women who had had a normal non-diabetic pregnancy (control women) approximately one year after delivery. We hypothesised that the women who had had GDM would on the whole have more abdominal obesity than control women, that they would be relatively hyperinsulinemic and hyperglycemic, and that they would have a characteristic dyslipidemia on fasting (high VLDL, IDL and LDL and low HDL concentrations, high plasma non-esterified fatty acid (NEFA) concentration and cholesteryl ester transfer protein (CETP) activity in plasma, more small LDL and HDL particles). It was expected that these women would have been more likely to have a family history of NIDDM. We hypothesised also that the women who had had GDM would have a high plasma testosterone and low plasma sex hormone binding globulin (SHBG) concentration, would have higher blood pressure, and be more likely to have microalbuminuria than control women. Many of these predictions were borne out. The study shows that the population of women who have had GDM are overall far from normal one year after the end of pregnancy. They are likely to have a set of abnormalities which our current knowledge suggests are precursors of the insulin resistance syndrome such as obesity, a positive family of diabetes mellitus, dyslipidemia, hyperinsulinemia, hyperandrogenicity, raised blood pressure, and microalbuminuria.