Gestational Diabetes, Pregnancy Hypertension, and Late Vascular Disease

Carpenter, Marshall W.

doi:10.2337/dc07-s224

Cited by 232 publications

(186 citation statements)

References 25 publications

(12 reference statements)

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“…GDM predicts later manifestation of the metabolic syndrome including T2DM, both associated with vascular dysfunction and atherogenesis, and so these two metabolic abnormalities may be intimately connected (30). Women with a history of GDM have a markedly elevated risk of CHD compared with women without a history of same (31).…”

Section: Discussionmentioning

confidence: 99%

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

O’Reilly

Avalos

Dennedy

et al. 2011

European Journal of Endocrinology

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Objective: Gestational diabetes (GDM) is associated with adverse fetal and maternal outcomes, and identifies women at risk of future type 2 diabetes mellitus (T2DM). Breast-feeding may improve post partum maternal glucose tolerance. Our objective was to identify the prevalence of post partum dysglycemia after GDM, to delineate associated factors and to examine the effect of lactation on post partum glucose tolerance. Design: We compared post partum 75 g oral glucose tolerance test (OGTT) results from 300 women with GDM and 220 controls with normal gestational glucose tolerance (NGT) in five regional centers. Breast-feeding data was collected at time of OGTT. Methods: Post partum OGTT results were classified as normal (fasting plasma glucose (FPG) !5.6 mmol/l, 2 h !7.8 mmol/l) and abnormal (impaired fasting glucose (IFG), FPG 5.6-6.9 mmol/l; impaired glucose tolerance (IGT), 2 h glucose 7.8-11 mmol/l; IFGCIGT; T2DM, FPG R7 mmol/lG2 h glucose R11.1 mmol/l). Binary logistic regression was used to identify factors predictive of persistent hyperglycemia. Results: Five hundred and twenty women were tested; six (2.7%) with NGT in pregnancy had post partum dysglycemia compared with 57 (19%) with GDM in index pregnancy (P!0.001). NonEuropean ethnicity (odds ratio (OR) 3.40; 95% confidence interval (CI) 1.45-8.02, PZ0.005), family history of T2DM (OR 2.14; 95% CI 1.06-4.32, PZ0.034), and gestational insulin use (OR 2.62; 95% CI 1.17-5.87, PZ0.019) were associated with persistent dysglycemia. The prevalence of persistent hyperglycemia was significantly lower in women who breast-fed vs bottle-fed post partum (8.2 vs 18.4%, P!0.001). Conclusions: Non-European ethnicity, gestational insulin use, family history of T2DM, and elevated body mass index were associated with persistent dysglycemia after GDM. Breast-feeding may confer beneficial metabolic effects after GDM and should be encouraged. European Journal of Endocrinology 165 953-959

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Section: Discussionmentioning

confidence: 99%

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

O’Reilly

Avalos

Dennedy

et al. 2011

European Journal of Endocrinology

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“…Insulin resistance has been shown to be a contributing factor to both chronic (17) and gestational hypertension (18), and it is known to be involved in the pathogenesis of GDM (19). Endothethial dysfunction has been found in women with GDM both during (20) and after (21) pregnancy and is also closely related to hypertension (22).…”

Section: Methodsmentioning

confidence: 99%

High Blood Pressure Before and During Early Pregnancy Is Associated With an Increased Risk of Gestational Diabetes Mellitus

Hedderson

Ferrara

2008

Diabetes Care

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OBJECTIVE -While women with prior gestational diabetes mellitus (GDM) are more likely to display features of the metabolic syndrome, including hypertension, in the years after delivery, it is unclear whether these components are also present before pregnancy. We examined the relationship between blood pressure (BP) measured before and during early pregnancy (Ͻ20 weeks) and the risk of GDM in a nested case-control study.RESEARCH DESIGN AND METHODS -Case (n ϭ 381) and control (n ϭ 942) subjects were selected from a cohort of women delivering between 1996 and 1998 and screened for GDM between 24 and 28 weeks' gestation. GDM was defined by the National Diabetes Data Group criteria. BP and covariates data were obtained by review of the medical records. Women were categorized according to BP levels recommended by the American Heart Association outside of pregnancy: Ͻ120/80 mmHg (normal), 120 -139/80 -89 mmHg (prehypertension), and Ն140 and/or Ն90 mmHg or use of antihypertensive medications (hypertension). CONCLUSIONS -Clinicians should be aware that women presenting with hypertension may warrant early screening or intervention to prevent GDM. RESULTS

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“…GDM is associated with increased cardiovascular risk later in mother's life (Carpenter, 2007). In the various recent studies, the pathological changes in 24 h blood pressure profile, echocardiography evaluation and heart rate variability were reported in women with GDM (Poyhonen-Alho et al, 2010, Soydinc et al, 2013.…”

Section: Discussionmentioning

confidence: 99%

A study on the analysis of heart rate variability among women with gestational diabetes mellitus

Bhatnagar¹,

Srivastava²

2017

IJMSCI

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Abstract:Objective: To analyze heart rate variability (HRV) among women with gestational diabetes mellitus. Methods: A total of 60 women of >20 weeks gestational age were included (30 cases and 30 controls). All the subjects of the study were undergone an oral glucose tolerance tests (oGTT) generating diagnostic indicators for gestational diabetes mellitus (GDM). The recording of short term HRV was done according to the recommendation of the task force on HRV. Following 10 minutes of supine rest in autonomic laboratory of department of physiology, all leads of HRV was placed over the subject in requisite position. Lead II of ECG was recorded during supine rest using Medicaid 4 channel system. Results: There was no significant (p>0.05) difference in age, height, weight and BMI between cases and controls showing the comparability of the groups. Both systolic and diastolic blood pressure was found to be significantly (p=0.0001) higher among cases compared to controls. Peak frequency (in Hz) and peak power (%) were found to be significantly (p=0.0001) higher among cases compared to controls. Conclusion: results of study demonstrate that there was significant higher HRV in the patients with GDM than controls.

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Gestational Diabetes, Pregnancy Hypertension, and Late Vascular Disease

Cited by 232 publications

References 25 publications

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

High Blood Pressure Before and During Early Pregnancy Is Associated With an Increased Risk of Gestational Diabetes Mellitus

A study on the analysis of heart rate variability among women with gestational diabetes mellitus

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