New research by Drs Ravi Retnakaran and Caroline Kramer of Leadership Sinai Centre for Diabetes, shows that in women who develop gestational diabetes during pregnancy, the risk of cardiovascular disease in the years following childbirth is doubled compared to women who do not develop gestational diabetes. This increased risk remains even if women who had gestational diabetes do not go on to develop full blown type 2 diabetes. The study was published in Diabetologia, the journal of the European Association for Study of Diabetes.
It was previously known that women who develop gestational diabetes have an elevated lifetime risk of going on to develop type 2 diabetes -at least seven times higher than women without a history of gestational diabetes. It was also known that women with gestational diabetes had elevated risk of cardiovascular risk, however it was not understood if the risk was associated with type 2 diabetes.
In this new study, the Sinai Health System physicians and researchers found that the two-fold increase in risk of cardiovascular disease in women with gestational diabetes is not dependent on developing type 2 diabetes.
“Even without progressing to type 2 diabetes, women with gestational diabetes are an at-risk population for cardiovascular disease, and hence a potential opportunity for early risk factor surveillance and risk modification,” said Dr. Retnakaran.
The study looked at data from over five million women in USA, Canada, UK, France, Israel and Sweden. The study also offers insight into possible mechanisms of diabetes and cardiovascular disease, such as the link with inflammatory markers such as C-reactive protein, higher levels of blood fats, low levels of HDL (good) cholesterol and higher levels of LDL (bad) cholesterol.
“Taken together, this study supports the emerging concept that women who develop gestational diabetes may actually have a chronic metabolic disorder that comes to clinical attention during gestation, although it exists before, during and after the pregnancy. In this way, the diagnosis of gestational diabetes may be seen as identifying women who have a long-standing, high-risk cardiometabolic profile that would otherwise escape clinical detection during the relative youth of their childbearing years, if not for the screening that they undergo during pregnancy that will diagnose the gestational diabetes. This provides us with a unique window into a woman ’s future risk, allowing for possible increased monitoring and prevention strategies.”
Dr. Retnakaran’s research programme is supported by the Sun Life Financial Program to Prevent Diabetes in Women.