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Cardiovascular Disease Risk Increased in Women Following Gestational Diabetes

Young women with gestational diabetes mellitus (GDM) are at significantly increased risk of developing cardiovascular disease, compared to women without GDM, according to a new study. "Gestational diabetes mellitus is a common condition affecting 2% to 4% of pregnant women," write Dr. Baiju Shah, of the Institute for Clinical Evaluative Sciences in Toronto, and colleagues.

They assessed rates of cardiovascular disease (CVD) in women who were between the ages of 20 and 49 years and had live births between April 1994 and March 1997 in Ontario.

Of 351,685 eligible subjects, 2.3% had GDM during the index pregnancy. For the analysis, 8191 women with GDM were matched to 81,262 women without GDM. Both groups had a mean age of 31 years. The median follow-up time was 11.5 years.

Overall, 2214 (27.0%) of women with GDM and 2596 (3.2%) of women without GDM developed diabetes during follow-up.

The unadjusted hazard ratio for CVD events was 1.71 for women with a history of gestational diabetes. The risk was attenuated after adjustment for subsequent type 2 diabetes, with a hazard ratio of 1.13.

"In summary, women with GDM are at increased risk for CVD events compared with women without GDM, and much of this risk is attributable to the subsequent development of type 2 diabetes," Dr. Shah and colleagues conclude. "As diabetes prevention interventions in women with a history of GDM have also been shown to slow progression of atherosclerosis, this study highlights the importance of diabetes prevention for this high-risk population."
Diabetes Care 2008;31:1668-1669.

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