Women who have gestational diabetes mellitus (GDM) during pregnancy have a higher than usual risk of developing type 2 diabetes, hypertension, and ischemic heart disease in the future, according to a retrospective cohort study published this week in PLOS Medicine by Krishnarajah Nirantharakumar from the University of Birmingham, UK, and colleagues.
Rates of GDM are increasing in most developed countries, and previous research has found that women diagnosed with GDM have an increased lifetime risk of developing type 2 diabetes. In the new study, researchers studied the incidence of type 2 diabetes, hypertension and ischemic heart and cerebrovascular diseases in a UK primary care database that included more than 9,000 women diagnosed with GDM between 1990 and 2016.
Women diagnosed with GDM were over 20 times more likely to be diagnosed with type 2 diabetes later in life, over two and a half times more likely to develop ischemic heart disease and almost twice as likely to develop hypertension. Although current guidelines recommend annual screening for diabetes in women diagnosed with GDM, the study also found that follow-up screening for diabetes as well as cardiovascular risk factors was low, with the exception of blood pressure; less than 60% of women were screened in the first year post-partum and rates declined thereafter.
"The findings add an important insight into the trajectory of the development of type 2 diabetes, hypertension and cardiovascular disease in the early and latter post-partum periods," the authors say. "Furthermore, the findings are the first to report on a large UK population and identify an at-risk group of relatively young women ideally suited for targeting risk factor management to improve long term metabolic and cardiovascular outcomes."
No direct funding was received for preparing this manuscript. All authors were funded by their respective institutions. No specific salary was set aside for writing this manuscript.
The authors have declared that no competing interest exist.
Daly B, Toulis KA, Thomas N, Gokhale K, Martin J, Webber J, et al. (2018) 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 15(1): e1002488. https://doi.org/10.1371/journal.pmed.1002488
School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
Department of Diabetes, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Diabetes and Endocrinology, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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