Background:
The past two to three decades have witnessed a huge increase in the prevalence of and numbers of people with obesity and type 2 diabetes and data also indicate an increase in gestational diabetes. These diseases also disproportionately affect disadvantaged and minority groups in the US and poorer nations worldwide. Several factors have been implicated for the rise in diabetes: genetic susceptibility, obesity, sedentary behavior, and dietary factors.
1 in 3 people in the US will develop diabetes in their lifetime, and diabetes affects 22 million people currently and is projected to affect 48 million people by 2050. Worldwide, nearly 200 million people have diabetes and by 2030, 400 million people will likely have diabetes. Type 2 Diabetes is associated with other cardio-metabolic abnormalities, notably – obesity, dyslipidemia, and hypertension.
The metabolic environment during conception and during pregnancy is associated with adverse pregnancy outcomes, birth defects, and also a higher risk of obesity and diabetes in the offspring. The precise role of insulin resistance and glucose intolerance in these outcomes are under exploration. Regardless of the etiological mechanisms, the importance of good metabolic control pre-conception and peri-conception cannot be under-estimated.

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