Women diagnosed with gestational diabetes mellitus (GDM) are at a very high risk of developing Type 2 diabetes and have a significantly increased incidence of hypertension and ischemic heart disease (IHD), according to recently published research in PLOS Medicine.
“Although the association between GDM and Type 2 diabetes is well established, onset of the latter following delivery is less well documented and understood in terms of underlying genetic and lifestyle factors,” wrote lead author Barbara Daly, PhD, RN, University of Auckland in New Zealand. “Only 3 previous large population-based studies quantifying the increased risk of cardiovascular disease following delivery in women diagnosed with GDM were identified.”
The researchers examined the association between GDM and development of Type 2 diabetes, hypertension and postpartum cardiovascular disease in women previously diagnosed with GDM between Feb. 1, 1990, and May 15, 2016.
In the retrospective study, more than 9,000 women with GDM were identified using the Health Improvement Network and randomly matched to a control group of more than 37,000 pregnant women who did not have GDM.
Adjusting for age, smoking and body mass index (BMI), the researchers reported gestational diabetics were 20 times more likely to develop Type 2 diabetes, 2.8 times more likely to develop hypertension and twice as likely to develop IHD. There was no association found for cerebrovascular disease.
The researchers also noted, of the women diagnosed with GDM, 58 percent were screened in their initial year postpartum and continued to decrease at 40 and 24 percent, respectively, at two and three years.
“The findings report on a large population and identify an at-risk group of relatively young women ideally suited for targeting of risk factor management to improve long-term metabolic and cardiovascular outcomes,” the authors concluded. “Targeting these high-risk women may also provide better value for money for prevention programs, as they are already known to general practice. While the value of preventing cardiovascular outcomes requires further studies, there is some evidence that targeting this subgroup of women may yield benefits in reducing conversion to type 2 diabetes.”