Gestational Diabetes Mellitus and Cardiovascular Risk after Pregnancy

Abstract

Gestational diabetes mellitus (GDM) affects many women in pregnancy and is enhanced by epidemic conditions of obesity, increasing age at the time of the first pregnancy, stressful life conditions, a sedentary lifestyle with less physical activity and unhealthy nutrition with highly processed, high-calorie food intake. GDM does not affect the mother and offspring in pregnancy alone, as there is compelling evidence of the long-term effects of the hyperglycemic state in pregnancy postpartum. Type 2 diabetes mellitus, cardiovascular disease and metabolic syndrome are more common in GDM women, and even the offspring of GDM women are reported to have higher obesity rates and a higher risk for noncommunicable diseases. Early prevention of risk factors seems to be key to overcoming the vicious cycle of cardiometabolic disease onset.

Obese Nondiabetic Pregnancies and High Maternal Glycated Hemoglobin at Delivery as an Indicator of Offspring and Maternal Postpartum Risks: The Prospective PEACHES Mother-Child Cohort

“…We confirmed this association in a separate group of obese women with a diagnosis of GDM, and it appeared to be slightly stronger than that seen in the subgroup of obese GDM-negative women. The association of GDM with the development of postpartum type 2 diabetes and cardiovascular risk factors is well established (34,35 ). However, the finding of gestational dysglycemic states associated with increased Hb A 1c at delivery and a risk of later-life health disturbances has not yet been realized as a problem of obese pregnancies.…”

Effects of calcium–vitamin D co-supplementation on glycaemic control, inflammation and oxidative stress in gestational diabetes: a randomised placebo-controlled trial

“…Overall, 4.7% of pregnant women in Iran are affected by this condition [3]. Various factors, including older age at the time of the first pregnancy, stressful life conditions and a sedentary lifestyle along with less physical activity, inappropriate diet and high-energy food intake, have been reported to increase the risk [4]. GDM is associated with insulin resistance, vascular dysfunction, vascular disease, macrosomia, neonatal hypoglycaemia, hyperbilirubinaemia [5], Caesarean section, pre-eclampsia and preterm delivery [6].…”

Dysregulation of gene expression in human fetal endothelial cells from gestational diabetes in response to TGF-β1

“…GDM is associated with enhanced risk of cardiovascular disease in women and offspring [3]. In utero exposure to GDM is associated with an increased risk of type 2 diabetes and cardiovascular disease in later life [4,5].…”