Gestational diabetes – glucose intolerance occurring during pregnancy – is relatively common, affecting around four in every hundred pregnancies. A lot of research has linked low birth weight in babies born to mothers with diabetes to increased risk of vascular disease in later adult life. But much less attention has been focused on the mother’s subsequent health risks after having gestational diabetes. In this article, we review the increased risk of diabetes and vascular disease in later life in women suffering gestational diabetes and how to improve follow-up and prevention.