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Gestational Diabetes and Heart Disease

6/26/2018 12:03:59 PM
Gestational diabetes mellitus is a well-documented risk factor for type 2 diabetes, and 3 previous population-based studies (conducted in Canada, France, and North America) have also reported that gestational diabetes increases the risk for future cardiovascular events. The current study examined the risk of cardiovascular disease in women previously diagnosed with gestational diabetes in the United Kingdom.
The retrospective cohort study relied on data from 9118 women diagnosed with gestational diabetes between 1990 and 2016 and randomly matched with 37,281 controls. The primary outcome measures were diagnoses of coronary artery disease (ischemic heart disease) or cerebrovascular disease (stroke and transient ischemic attack). Secondary outcomes were incident hypertension and type 2 diabetes. Adjusted incidence rate ratios (IRRs) were calculated for these outcomes.
Compared with controls, women with previous gestational diabetes were over 20 times more likely to develop type 2 diabetes (IRR=21.96; 95% CI, 18.31-26.34; p<.001), 2.8 times more likely to develop ischemic heart disease (IRR=2.78; 95% CI, 1.37-5.66; p=.005), and almost 2 times more likely to develop hypertension (IRR=1.85; 95% CI, 1.59-2.16; p<.001). These increased risks persisted for the entire 25-year follow-up period. There was no association found for cerebrovascular disease.
The study also found that less than 60% of women were screened for diabetes in the first year after delivery and that percentage dropped to less than 40% during the second year. The authors of the study emphasize a need for greater awareness and screening of women with previous gestational diabetes for diabetes, hypertension, and heart disease.  
Daly B, Toulis KA, Thomas N et al. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study. PLoS Med. 2018; 15: e1002488.