Our finding that women with GDM who are overweight are at particular risk for later severe CVD has not been shown previously, as earlier work identified an association with the less severe outcome of hypertension. GDM was rarer among the normal weight women reflecting the fact that the aetiology of GDM differs. The aetiology of GDM in overweight women may be more closely related to components of the metabolic syndrome,15 while among normal weight women autoimmune and monogenic diseases are more frequently the causes.16,17 Women with GDM have characteristics of hyperinsulinaemia
and hyperlipidaemia with the metabolic syndrome, which is also a risk for future CVD