Gestational diabetes linked to greater risk of heart disease later in life

by Barbara Hewitt on March 18, 2014

Women who have gestational diabetes may face an increased risk of early heart disease later in life, even if they do not develop type 2 diabetes after their pregnancy, a new study suggests.

Research by managed health care consortium Kaiser Permanente based in California, US, shows that just having a history of gestational diabetes elevates a woman’s risk of developing early atherosclerosis before she develops type 2 diabetes or metabolic syndrome.


Research shows that just having a history of gestational diabetes elevates a woman’s risk of developing early atherosclerosis

‘Pregnancy has been under recognised as an important time period that can signal a woman’s greater risk for future heart disease. This signal is revealed by gestational diabetes,’ said Erica Gunderson, study lead author and senior research scientist in the Kaiser Permanente Division of Research in Oakland.

Gestational diabetes, a condition during pregnancy that sees a woman’s blood sugar rise usually disappears after the pregnancy. It is managed with meal planning, activity and sometimes insulin or other medications.

In this 20 year study, researchers assessed risk factors for heart disease before pregnancy among 898 women, 18 to 30 years old, who later had one or more births. The women were periodically tested for diabetes and metabolic conditions before and after their pregnancies.

Using ultrasound, researchers measured the thickness of the walls of participants’ carotid artery, which circulates blood to the neck and face. Carotid artery wall thickness is an early measure of atherosclerosis, plaque buildup in arteries, and predicts heart attack and stroke in women. The artery’s thickness was measured on average 12 years after pregnancy.

Researchers found a larger average carotid artery wall thickness in study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome during the 20 year follow up compared to those who never experienced gestational diabetes. The difference was not attributed to obesity or other risk factors for heart disease that were measured before pregnancy.

It’s important to recognize reproductive characteristics that may contribute to disease risk in women, Gunderson said. ‘It’s a shift in thinking about how to identify a subgroup at risk for atherosclerosis early. The concept that reproductive complications unmask future disease risk is a more recent focus. It may inform early prevention efforts,’ she pointed out.

This study is part of Kaiser Permanente’s ongoing efforts to better understand gestational diabetes. Last year, Kaiser Permanente researchers found that pre-pregnancy obesity and older maternal age are among the risk factors for delayed lactation for women with gestational diabetes.

Kaiser Permanente can conduct transformational health research in part because it has the largest private patient centered electronic health system in the world. It securely connects 9.1 million patients to more than 16,000 physicians in nearly 600 medical offices and 38 hospitals.

It also connects Kaiser Permanente’s research scientists to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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