Mokkala K, Vahlberg T, Houttu N, et al. - This study was undertaken to determine if the presence of gestational diabetes (GDM) and its treatment mode influence the serum metabolic profile in women with overweight or obesity. Serum metabolic profiles of 352 overweight or obese women taking part in a mother‐infant clinical study were analyzed using a targeted nuclear magnetic resonance approach (at 35.1 median gestational weeks). A 2‐hour 75‐g oral glucose tolerance test was used to diagnose GDM. The women treated with medication had higher concentrations of VLDL particle severalizes and their components, leucine, and isoleucine, as well as glycoprotein acetylation relative to women with GDM treated with diet only. GDM detected a clearly distinct metabolic profile which deviated more if the patient received medical care. This indicates that women with GDM need more intensive follow-up and counseling during pregnancy and postpartum to reduce their adverse health risks in the long term.