Alessia Gaglio1 · Yana Pigotskaya1 · Gabriele Rossi2 · Marco Mirani3 · Federico Giacchetti5 · Valeria Grancini1 · Valeria Maggi2 · Giovanna Mantovani1,4 · Irene Cetin2,4 · Emanuela Orsi5 · Veronica Resi1
Received: 21 November 2025 / Accepted: 17 January 2026
© The Author(s) 2026
Abstract
Background Women with previous gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mel-litus (T2DM). Although early postpartum screening is recommended, metabolic changes occurring during the first year remain poorly characterized, and Italian guidelines do not include assessment at this time point.
Aim To evaluate glycaemic and metabolic changes one year after delivery in women with previous GDM and identify clini-cal and lifestyle predictors of postpartum glucose impairment.
Methods A cohort of 134 women with prior GDM was assessed at 6–12 weeks (T0) and one year postpartum (T1). Anthro-pometric, biochemical, nutritional, lifestyle, and quality-of-life parameters were collected. Dietary habits were evaluated using a 3-day food diary and the PREDIMED questionnaire; physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Logistic regression models were used to identify predictors of altered OGTT at T1.
Results At baseline, 32.9% of women showed altered OGTT; this increased to 38.8% at one year, while T2DM prevalence rose from 2.2 to 5.2%. Insulin therapy during pregnancy was the only independent predictor of dysglycaemia at T1 (OR 3.5, 95% CI 1.28–9.50, p=0.015). Women with altered OGTT reported lower SF-36 scores in the domains “role limitations due to physical health” (p=0.016) and “health change” (p=0.030). Breastfeeding was associated with more favourable glucose outcomes (p=0.009).
Conclusions One-year follow-up after GDM reveals early metabolic and psychosocial differences not detectable in the early postpartum period. Insulin therapy during pregnancy strongly predicts glucose impairment, highlighting the need for extended postpartum surveillance and targeted lifestyle interventions.
Keywords Gestational diabetes · Postpartum follow-up · Impaired glucose tolerance · Lifestyle · Breastfeeding
Communicated by Annunziata Lapolla.
Alessia Gaglio
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1 Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
2 Obstetric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
3 Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
4 Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
5 Diabetology and Nutritional Unit, Department of Specialist Medicine, ASST Santi Paolo e Carlo, Milan, Italy
Sara Ferrigno1 · Eneida Çela1 · Mauro Fatica1,2 · Benedetta Monosi1 · Arianna D’Antonio1 · Paola Conigliaro1 · Marina Cardellini3,4 · Susanna Longo3,4 · Massimo Federici3,4 · Maria Sole Chimenti1
Received: 20 February 2026 / Accepted: 26 March 2026 © The Author(s) 2026
Rheumatoid arthritis (RA) is an inflammatory disease characterized by a higher burden of cardiovascular and metabolic diseases than in the general population. Altered lipid and glucose metabolic pathways are widely observed, primarily due to chronic inflammation. However, metabolic dysfunction may also affect RA pathogenesis, further enhancing immune cell activation and joint damage. Glucose and lipid alterations observed in RA help define the comorbidity burden of this disease, significantly affecting disease activity and prognosis. The aim of the present review is to describe the role of metabolic dysfunctions in RA and to examine how disease activity and treatments can influence these conditions. We also summarized the main management strategies based on current literature and developed a cardiometabolic monitoring algorithm across different clinical settings to support daily patient care of these patients.
Keywords Rheumatoid arthritis · Glucose metabolism · Lipid metabolism · Atherogenesis · Inflammation · Immune-metabolism · Cardiovascular risk
Sara Ferrigno and Eneida Çela contributed equally to this manuscript
Communicated by Salvatore Corrao, M.D
Sara Ferrigno
1 Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
2 Academic Rheumatology Unit, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Giovanni Paolo II, C/da Tappino, Campobasso 86100, Italy
3 Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
4 Center for Atherosclerosis, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Authors
Kevin Kelleher
Rhona Hunt
Hülya Leblebicioğlu
Leyla Khorshid
Sheena A. Gagnier
Barbara A. Pieper
Barbara Zeiger
Christopher Edens
Patricia Stevenson
Evan S. Darwin
Jose A. Jaller
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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