January 17, 2018
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Gestational diabetes confers risk for type 2 diabetes, hypertension, CHD

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Barbara Daly

Women with gestational diabetes had elevated risk for type 2 diabetes, hypertension and ischemic heart disease, according to the results of a retrospective cohort study.

The researchers compared 9,118 women diagnosed with gestational diabetes with 37,281 control women matched by age and timing of pregnancy from a primary care database in the United Kingdom to determine relationships between gestational diabetes, CV risk factors and CVD.

Median age at delivery was 33 years (range, 14-47). Median follow-up was 2.9 years.

Compared with controls, women with gestational diabetes were more likely to develop type 2 diabetes (incidence rate ratio [IRR] = 21.96; 95% CI, 18.31-26.34) and hypertension (IRR = 1.85; 95% CI, 1.59-2.16) even after adjustment for age, Townsend (deprivation) quintile, BMI and smoking, Barbara Daly, PhD, RN, MHS, from the school of nursing, faculty of medical and health sciences, University of Auckland, New Zealand, and colleagues wrote.

After adjustment for age, Townsend (deprivation) quintile, BMI, smoking, hypertension and lipid-lowering medication, gestational diabetes was associated with elevated risk for ischemic heart disease (IRR = 2.78; 95% CI, 1.37-5.66) but not cerebrovascular disease (IRR = 0.95; 95% CI, 0.51-1.77), according to the researchers.

Follow-up screening for type 2 diabetes and CV risk factors except BP was poor, Daly and colleagues wrote. Among women with gestational diabetes, glycemic screening occurred in 58% in the first year after delivery, but that dropped to less than 40% in the second and third years, with 24% of women having no glycemic measurement at all in 3 years. Only 28% of women with gestational diabetes had any cholesterol level recorded within 3 years of delivery, and only 23% had triglyceride levels recorded during that time.

“Guideline recommendations for screening and management of hypertension, lipids and smoking cessation are lacking and need to be reviewed,” the authors wrote. – by Erik Swain

Disclosures: The authors report no relevant financial disclosures.