Among women with a family history of type 2 diabetes, those with prior GDM were more likely to have CVD risk factors. We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with first-degree relatives with type 2 diabetes.
Women with (n = 332) and without (n = 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD.
Women with prior GDM were younger and less likely to be postmenopausal. Although both groups were obese, women with prior GDM were more likely to have metabolic syndrome and type 2 diabetes. Moreover, they had a higher prevalence of CVD that occurred at a younger age and was independent of metabolic syndrome and type 2 diabetes.
In this population of women with a family history of type 2 diabetes, we found that prior GDM was associated with an increased prevalence of CVD. Moreover, the diagnosis of CVD occurred at a significantly younger age in these women. Thus, a history of GDM, among women whom are all at risk of CVD due to their family history of type 2 diabetes, identifies individuals with a propensity for cardiovascular risk factors that manifest as a significantly higher prevalence of CVD. Furthermore, the increased prevalence of CVD in these women was above and beyond the risk associated with the metabolic syndrome, type 2 diabetes, and proband status.
In keeping with their higher prevalence of CVD, women with prior GDM had greater central adiposity, higher fasting insulin levels compatible with them being more insulin resistant, higher LDL and non-HDL cholesterol levels, and a significantly increased prevalence of hypertension compared with women without a history of GDM.
In the past few years, it has become apparent that lifestyle and pharmacological interventions are capable of slowing or possibly preventing the development of type 2 diabetes in high-risk individuals.
From the results it was concluded that among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.
Diabetes Care 29: 2078-2083.
For the diabetic patient, it’s not the cholesterol that’s the problem. It’s the number of LDL particles, especially small LDL particles. To see the real risk, use the NMR LipoProfile(r) test, the only test that directly measures the number of LDL particles and the number of small LDL particles – the particles shown to be more predictive of CHD events than LDL-C. Click here to learn more.