Aim: Prevalence of glucose metabolism disorders in women six years after gestational diabetes in the index pregnancy (GDM). Method: 227 Caucasian women who developed GDM between 1995 and 1996 were investigated; 173 women (BMI 27.5 ± 6.0 kg/m2) received 75 g oGGT on average 5.8 ± 2.0 years after delivery. Results: Impaired glucose metabolism was found in 31.2 %, IGT or IFG 19.1 %, diabetes mellitus type 2 (DM2) 9.2 %, diabetes mellitus type 1 (DM1) 2.3 %, second GDM 0.6 %. 27.2 % (BMI 25 - 29.9 kg/m2) were overweight, 23.1 % suffered from obesity (BMI 30 - 39.9 kg/m2) and 5.2 % morbid obesity (BMI ≥ 40 kg/m2). In comparison to a healthy control group, women with DM2 at re-examination were: older in age (32.1 ± 5.9 vs. 29.1 ± 4.8 years, p < 0.05), had higher BMI (29.4 ± 6.9 vs. 24.6 ± 4.8 kg/m2, p < 0.05), higher fasting blood glucose (6.5 ± 1.9 vs. 5.2 ± 0.9 mmol/l, p < 0.05), earlier diagnosis of GDM (25 ± 8 vs. 29 ± 5 SSW, p < 0.05), more frequent insulin therapy during pregnancy (75 vs. 24 %) and had significantly higher insulin- and C-peptide for all measures of the oGTT, whereas HbA1c was not different (4.9 ± 0.5 vs. 4.8 ± 0.3 %, n. s.). Conclusion: In an average of 5.8 years after the diagnosis of GDM, the majority of women still have chronic insulin resistance. One third has either IGT, IFG or diabetes mellitus. Therefore, a long term follow-up is strongly recommended for women diagnosed with GDM.