Excessive gestational weight gain and gestational diabetes: importance of the first weeks of pregnancy

Gestational diabetes mellitus (GDM) is associated with many adverse neonatal and maternal outcomes and prevention of this condition is considered a key strategy for breaking the intergenerational cycle of obesity and diabetes. Whether prevention of excessive gestational weight gain in the first weeks of pregnancy is associated with a reduced risk for GDM is currently unclear. In this issue of Diabetologia, Brunner et al (DOI: 10.​1007/​s00125-015-3686-5) address this possible association by conducting a systematic review and a meta-analysis. The results of their study provide evidence that excessive gestational weight gain prior to a GDM screening test is associated with an increased risk of GDM compared with non-excessive gestational weight gain. These results emphasise the need for appropriate preconception care and for better prevention of early excessive gestational weight gain and GDM.