Purpose: GDM increases the risk of type 2 diabetes mellitus (T2DM) and also has adverse effects on the health status of offspring. This clinical guideline covers the postpartum period, with specific references to prevention, screening, diagnosis, and management of T2DM in mothers with a history of GDM and their children.
Methods: The present research is a clinical guideline for women who experienced GDM. Clinical questions were created based on the PICO framework at the outset, and appropriate evidence was searched in electronic databases like PubMed, Scopus, and WOS. Two rounds of the Delphi technique were employed to achieve consensus among experts and led to the final draft of the guideline, which consisted of six guiding questions and 37 clinical recommendations. Quality appraisal of the guidelines was conducted by the AGREE instrument, an instrument for assessing six domains of guideline quality based on 23 confirmed criteria.
Results: The final guideline includes 37 recommendations that are divided into six separate modules: risk factors, prevention, screening, diagnosis, and diagnostic measures, postpartum follow-up, education, and care, recurrent pregnancy, and pharmacologic interventions. The key recommendations in this guideline include lifestyle changes, commencement of metformin, and a structured postpartum follow-up plan to lower the risk of T2DM.
Conclusion: This Clinical practice guideline presents evidence-based suggestions to help prevent and manage T2DM in women with a history of GDM and in offspring, emphasizing lifestyle changes in exercise, diet, and breastfeeding. It reiterates the necessity of periodic glucose-tolerance screening tests, in addition to structured follow-up and patient education.
Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01689-3.
Keywords: Gestational diabetes mellitus (GDM); Lifestyle interventions; Metformin; Postpartum care; Prevention; Screening; Type 2 diabetes mellitus (T2DM).
© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.