News article

Gestational diabetes may raise risk for heart disease in midlife

Posted:  Tuesday, March 18, 2014

Almost all women become glucose intolerant as a result of hormonal changes during pregnancy. Their blood sugar spikes, but not enough to have diabetes. However, during their third trimester, these hormonal changes put women at the risk of getting gestational diabetes. Due to this, women may also face the risk of early heart disease. Early screening and prevention, is needed to identify the risk of heart disease in these mothers. There is also evidence suggesting early atherosclerosis during midlife and before the onset of diabetes and metabolic disease.

Gestational diabetes, normally develops during pregnancy and usually disappears after the pregnancy. However, this increase the risk of developing diabetes later. This condition can be managed with meal planning, activity and sometimes insulin or other medications. The condition is managed with meal planning, activity and sometimes insulin or other medications.

“Our research shows that just having a history of gestational diabetes elevates a woman's risk of developing early, sub-clinical atherosclerosis before she develops type 2 diabetes or the metabolic syndrome” said Erica P. Gunderson, Ph.D., M.S., M.P.H., study lead author and senior research scientist in the Division of Research at Kaiser Permanente Northern California in Oakland, Calif.

“Pregnancy has been under-recognized as an important time period that can signal a woman's greater risk for future heart disease. This signal is revealed by gestational diabetes, a condition of elevated blood sugar during pregnancy.”

During the 20 year study, researchers analysed the risk factors of heart disease before pregnancy among 898 women between the ages of 18-30 years, who had one or more children. These women were tested for diabetes or metabolic diseases before and after their pregnancies.

Another study was conducted on women between the ages of 38-50 years, almost 12 years after their pregnancies. The study controlled for age, race, number of births and pre-pregnancy body mass index, and fasting blood glucose, insulin, lipids, and blood pressure. Those who had gestational diabetes their carotid artery intima-media thickness was 0.023 larger as compared to those who didn’t have it, obesity and elevated glucose levels before pregnancy had no impact on it.

At the end of the study, only 13 women had cardiovascular problems and one had gestational diabetes.

“This finding indicates that a history of gestational diabetes may influence development of early atherosclerosis before the onset of diabetes and metabolic diseases that previously have been linked to heart disease," Gunderson said

The participants that, were part of the CARDIA study (Coronary Artery Risk Development in Young Adults) belonged to four urban areas. The study is a longitudinal analysis of women without previous heart disease or diabetes before the pregnancies.

Keeping a track of reproductive characteristics can aid in early prevention.

“It's a shift in thinking about how to identify a subgroup at risk for atherosclerosis early,” she said. “The concept that reproductive complications unmask future disease risk is a more recent focus,” she added.