Gestational Diabetes Mellitus

GDM is characterized by more severe insulin resistance and dysglycaemia than the physiological insulin resistance of normal pregnancy. The relationship between type 2 diabetes and sarcopenia has been described as bidirectional, suggesting sarcopenia may itself be a risk factor for GDM. GDM diagnosis in the SiGnal-D study uses International Association of Diabetes and Pregnancy Study Group criteria. Excluding GDM patients strengthens the trial's internal validity but limits its applicability to this high-risk population. GDM patients, as the subgroup arguably most at risk from perioperative glucose dysregulation, are excluded from this trial, limiting direct clinical applicability to them. GDM shares metabolic features with type 2 diabetes, particularly insulin resistance and beta-cell dysfunction. Mothers with gestational diabetes mellitus face heightened challenges in perioperative glucose management. The increasing frequency of pregnancies after age 40 is clinically relevant because sarcopenia prevalence is already non-negligible at that age. Elevated maternal glucose raises the risk of neonatal hypoglycaemia. Women who had GDM will undergo diagnostic OGTT at 6 to 12 weeks postp…