Gestational Diabetes Raises Risk
of Metabolic Syndrome
Approximately 7% of pregnancies will be
affected in 2003, up from 4% in 200.
Women who suffer from gestational diabetes or
preeclampsia are at heightened risk of developing
metabolic syndrome as soon as three years after
they give birth, a new study finds.
In the prospective study of more than 100 pregnant
patients, about 30% of those who suffered preeclampsia
or gestational diabetes during pregnancy developed
metabolic syndrome within 36 months compared with
only 5% of women who were healthy throughout their
pregnancy.
"This is very serious in terms of cardiovascular
disease risk," said Zsolt Bosnyak, MD, who
led the study while a postdoctoral fellow at the
University of Pittsburgh Graduate School of Public
Health in Pennsylvania.
"A history of pregnancy-induced disturbances
should be viewed as a potential marker for increased
risk of heart disease, with women monitored and
counseled accordingly," said Dr. Bosnyak,
who is now a clinician at the National Centre
for Diabetes Care in Budapest, Hungary.
Laurence Kennedy, MD, FRCP, professor of medicine
and chair of the Division of Endocrinology at
the University of Florida in Gainesville, agreed.
"Quite a lot of these women do not understand
that there will be long-term consequences,"
said Dr. Kennedy, who was not involved with the
trial. "They need to be taught to pay special
attention to symptoms and how to modify their
diet and exercise habits."
During a poster session at the American Diabetes
Association's 63rd Scientific Sessions here, Dr.
Bosnyak said he undertook the research to assess
the impact of skyrocketing rates of gestational
diabetes in the U.S. Approximately 7% of pregnancies
will be affected in 2003, up from 4% in 2001,
he said.
Also, previous studies on the long-term consequences
of high blood pressure and diabetes during pregnancy
have shown conflicting results, he noted.
Known as the Post Partum Insulin Resistance and
Cardiovascular Risk Study, the current trial enrolled
and followed the health status of 36 women with
preeclampsia, 33 women with gestational hypertension,
24 with gestational diabetes, and 31 healthy pregnant
women matched for age, sex, and prepregnancy body
mass index.
By three years' follow-up, women with gestational
diabetes were 12.5% more likely than controls
to suffer from hypertension, the study showed.
Women with preeclampsia or gestational hypertension
were 25% more likely than the control group to
develop high blood pressure in the follow-up period.
Triglyceride levels were 127 mg/dL in the gestational
diabetes group compared with 118 mg/dL in the
controls.
Also, 54.2% of women in the gestational diabetes
group developed insulin resistance compared with
41.7% of those in the preeclampsia group and 16.1%
of controls.
Those with gestational diabetes also had higher
glucose levels: 100 mg/dL vs. 87 mg/dL in the
control group. Serum insulin levels were also
higher: 24.6 U/mL vs. 14.5 U/mL in controls.
The study used the World Health Organization definition
of metabolic syndrome: Elevated insulin levels
or fasting blood glucose levels of 101 mg/dL to
109 mg/dL, along with two or more of the following:
abdominal obesity, dyslipidemia, and hypertension.
ADA 63rd Scientific Sessions: Abstract 1763. Presented
June 14, 2003.
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