Gestational diabetes (GDM) has increased risk of diabetes (DM2), a coronary artery disease (CAD) equivalent. The aim of this study was to determine the prevalence of impaired glucose metabolism (IGM) in GDM and its association with risk factors for CAD. A cohort of 109 women with GDM underwent a glucose tolerance test which classified them into three groups: diabetic (DM2) (fasting glucose (G) >= 126mg/dl or plasma glucose 2h (2-h G) >= 200 mg/dl); impaired glucose tolerance (IGT) (G 100-125 mg/dl and/or 2-h G 140-199 mg/dl); and normal (N) (G < 100 mg/dl and/or 2-h < 140 mg/dl). They were compared for pregestational (PBMI) and current (CBMI) body mass index, systolic (SBP) and diastolic blood pressure (DBP), G, lipids, fibrinogen and C-reactive protein (hsCRP). Thirty two months after delivery, 17.4% presented DM2, 39.4% IGT and 43.1% were N. PBMI, CBMI, SBP and DBP were significantly higher in the DM2 than N. G was higher in DM2 and IGT. HDL-cholesterol (HDLC) was higher in the N (p = 0.02) and the triglycerides (TG) were higher in DM2 (p = 0.02). The groups showed significantly different levels of hsCRP (p = 0.002). We conclude that the high prevalence of IGM, overweight/obesity, dyslipidemia and altered inflammatory markers, make GDM a high-risk situation for CAD. (C) 2007 Elsevier Ireland Ltd. All rights reserved.