Discussion
Our long-term follow-up study shows that pre-diabetes is
very frequent in women with a history of GDM. Gesta-
tional diabetes is strongly associated with both isolated im-
paired fasting glucose, isolated impaired glucose tolerance
and also their combination. Patients with GDM are more
insulin resistant than women who are normoglycemic dur-
ing pregnancy. However, impaired insulin secretion due to
beta cell failure seems to be the key defect leading to the
deterioration of hyperglycemia after a pregnancy affected
by GDM.