Updated: February 01, 2021, 5:36 p.m. IS
Washington [US], February 1 (ANI): Women with a history of diabetes during pregnancy (gestational diabetes) are twice as likely to develop calcium in the heart arteries by mid-life – a strong predictor of heart disease – even if they have healthy blood sugar levels many years after pregnancy new research achieved.
The study was published today in the American Heart Association’s flagship journal Circulation.
Gestational diabetes, which is high blood sugar (glucose intolerance) levels that were first detected during pregnancy, affects approximately 9% of US pregnancies and up to 20% worldwide. After pregnancy, women with gestational diabetes are at higher risk of developing prediabetes or type 2 diabetes. These are risk factors for cardiovascular disease.
Previous studies found a much higher risk of heart disease in women with a history of gestational diabetes who later developed type 2 diabetes. However, it remained unclear whether the risk of heart disease in women with a history of gestational diabetes was lower in women who achieved healthy glucose levels or who developed prediabetes in mid-life.
In 2018, the American College of Cardiology / American Heart Association’s Guidelines for Cholesterol Clinical Practice stated that a history of gestational diabetes increased a woman’s risk of arteries building up, leading to cardiovascular disease.
Using data from the multicenter, 30-year prospective Coronary Artery Risk Development in Young Adult (CARDIA) study, the researchers investigated whether achieving healthy blood sugar levels after pregnancy increased the risk of cardiovascular disease associated with gestational diabetes in the previous history would reduce.
“CARDIA is the first study to assess the risk of heart disease in women with a history of gestational diabetes compared to women without gestational diabetes many years later based on their blood sugar levels. Women with previous gestational diabetes were twice as likely to have calcium in the coronary artery, though They maintained normal blood sugar levels, later developed prediabetes, or were diagnosed with type 2 diabetes many years after pregnancy, compared to women without previous gestational diabetes who had normal blood sugar levels, “said Erica P. Gunderson, PhD, MS, MPH , Epidemiologist and senior scientist in the Cardiovascular and Metabolic Diseases Division of Kaiser Permanente’s Research Division in Oakland, California.
The CARDIA study enrolled more than 5,100 US men and women ages 18 to 30 when the study began in 1985. The new analysis includes approximately 1,100 women (49% black women and 51% white women) without Type 1 or type 2 diabetes, born at least once during the 25-year study period that ended in 2011. Blood tests were done every five years from before to after pregnancy to see if women had normal blood sugar levels and mean increases in blood sugar levels (prediabetes) or if they had developed overt type 2 diabetes. Cardiac exams were conducted to measure coronary artery calcium, a strong predictor of heart disease, at exams 15, 20, and 25 years after baseline, the first visit in the study.
At the 25-year follow-up, the median age of the participants was 48 years, and 12% of the women in the study had a pregnancy complicated by gestational diabetes. The prospective analysis showed:
– Women with a history of gestational diabetes were twice as likely to have coronary artery calcification, regardless of whether they had healthy blood sugar levels, prediabetes, or type 2 diabetes.
– Achieving healthy blood sugar levels after pregnancy did not reduce the risk of mid-life cardiovascular disease in women with previous gestational diabetes.
– Of women with previous gestational diabetes, 36% developed prediabetes and 26% developed type 2 diabetes, compared with 35% and 9% of women with no history of gestational diabetes.
-25% of women with a history of gestational diabetes had some coronary artery calcium levels versus 15% of women who never had gestational diabetes.
“We were surprised to discover that women with a history of gestational diabetes are at significantly higher risk of heart artery calcification even if they maintain normal blood sugar levels after pregnancy,” said Gunderson.
“Our results represent a paradigm shift in that they show that normal blood sugar after gestational diabetes is still associated with a higher risk of calcium in the coronary arteries,” the authors state.
“Heart disease risk assessment shouldn’t wait until a woman has developed prediabetes or type 2 diabetes,” Gunderson said.
“Diabetes and other health problems that develop during pregnancy are harbingers of future risk for chronic diseases, especially heart disease. Health systems need to keep history of gestational diabetes in health records and monitor risk factors for heart disease and recommended tests for type 2 -Diabetes in these women on a regular basis, which is critical to targeted prevention efforts. “
Limitations of the study include that the researchers did not measure coronary artery calcium levels prior to pregnancy, and coronary artery calcium levels were used as surrogate markers for risk of heart disease rather than cardiovascular events. (ANI)