Gestational Diabetes Increases Risk of Future Heart Disease

Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304MedicalResearch.com Interview with:
Erica P. Gunderson, PhD, MS, MPH
Senior Research Scientist, Cardiovascular and Metabolic Section
Division of Research, Kaiser Permanente Northern California
Oakland, CA 94612-2304


MedicalResearch.com: What are the main findings of the study?

Dr. Gunderson: The study found that:

–   Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease.

–   Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy.

–   Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes.  The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy.

–   Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness.


MedicalResearch.com: Were any of the findings unexpected?

 Dr. Gunderson: This is the first longitudinal study, and is unique in that pre-pregnancy risk factors were measured and controlled.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Gunderson: Cardiovascular disease is the leading cause of death in U.S. women.

Women who have a history of Gestational diabetes, and their health practitioners, should be aware that Gestational diabetes history reveals an increased risk of early atherosclerosis before overt metabolic disease develops.

Practitioners should consider monitoring women with previous Gestational diabetesmore closely by screening them for traditional heart disease risk factors after pregnancy.

Our finding that Gestational diabetes history reveals risk of early atherosclerosis before overt metabolic disease is important to primary prevention efforts, particularly for weight and blood pressure control.

Body size, blood pressure control and insulin resistance are important modifiable risk factors that may influence progression of atherosclerosis in women with previous GDM during midlife.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Gunderson: Future studies are needed to examine other modifiable behaviors in postpartum women such as breastfeeding, and their impact on lowering risk of early atherosclerosis in women with a history of gestational diabetes.

Citation:

History of Gestational Diabetes Mellitus and Future Risk of Atherosclerosis in Mid‐life: The Coronary Artery Risk Development in Young Adults Study

Erica P. Gunderson, Vicky Chiang, Mark J. Pletcher, David R. Jacobs, Charles P. Quesenberry, Stephen Sidney, and Cora E. Lewis

J Am Heart Assoc. 2014;3:e000490, originally published March 12, 2014, doi:10.1161/JAHA.113.000490

 

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