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Gestational diabetes ups cardiovascular risk

Young women who develop diabetes mellitus during pregnancy, also referred to as gestational diabetes, have an increased risk of cardiovascular disease, compared with women without gestational diabetes, according to the results of a Canadian study published in the journal Diabetes Care.

"Gestational Diabetes mellitus is a common condition affecting 2 to 4 percent of pregnant women," write Dr. Baiju Shah, of the Institute for Clinical Evaluative Sciences, Toronto, and colleagues. Many of these women return to normal blood glucose levels after the pregnancy, but an increased risk persists.

In their study, the researchers assessed more than 350,000 women between the ages of 20 and 49 years who delivered an infant between April 1994 and March 1997 in Ontario.

Shah's group found that 2.3% had developed gestational diabetes during pregnancy. For the analysis, 8191 women with gestational diabetes were matched to 81,262 women without gestational diabetes. The women in both groups were an average of 31 years old and the average follow-up time was 11.5 years.

Overall, 2,214 (27.0%) of the women with gestational diabetes and 2,596 (3.2%) of women without gestational diabetes when on to develop diabetes during the follow-up period.

Women with a history of gestational diabetes had a 71% increased risk of having a cardiovascular disease event following pregnancy. However, when those who did not develop diabetes after pregnancy were considered, the risk declined to 13%.

"In summary, women with gestational diabetes mellitus are at increased risk for cardiovascular disease events compared with women without gestational diabetes mellitus." However, most of the risk is "attributable to the subsequent development of type 2 diabetes," Shah and colleagues conclude.

"As diabetes prevention interventions in women with a history of gestational diabetes mellitus have also been shown to slow progression of atherosclerosis, this study highlights the importance of diabetes prevention for this high-risk population."
Source: Diabetes Care, August 2008
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