Gestational diabetes is a risk factor for developing type 2 diabetes and cardiovascular disease. A recent study on gestational diabetes using the CARDIA study data, revealed that women who had gestational diabetes for the first time and returned to normal blood glucose level had a two-fold risk of developing atherosclerotic CVD.

      The study cohort included 1133 women without diabetes at baseline, who had ≥1 singleton births (n=2066) during follow-up. Data on glucose tolerance testing, gestational diabetes status and Coronary artery calcium (CAC) measurements (measured by non contrast cardiac CT) were obtained from one or more examinations at 15, 20 and 25 years. Complementary log-log models for interval-censored data estimated adjusted hazard ratios of CAC and 95% confidence intervals for GD history and subsequent glucose tolerance groups (normoglycemia, prediabetes, or incident diabetes) on an average of 14.7 years after the last birth adjusted for prepregnancy and follow-up covariates.

      Researchers observed that gestational diabetes was associated with increased risk for ASCVD (HR = 1.85; 95% CI, 1.28-2.69) after adjustment for age, race and prepregnancy systolic BP. Additional adjustment for prepregnancy BMI and time-varying smoking slightly attenuated the risk (HR = 1.73; 95% CI, 1.18-2.52). Researchers suggested that sustained normoglycemia among women with previous gestational diabetes may not minimize future atherosclerotic cardiovascular disease risk in women during midlife. Also, a history of gestational diabetes may involve underlying vascular changes and pave the way to the development of CVD.

      These findings contribute to the mounting evidence that enhanced cardiovascular disease risk factor screening among women with a history of gestational diabetes is needed to better risk stratify women for early atherosclerotic CVD.