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Gestational Diabetes Mellitus Increases the Risk of Cardiovascular Disease in Women With a Family History of Type 2 Diabetes

¹ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
² Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington
³ Department of Rehabilitation Research and Development, University of Washington, Seattle, Washington
⁴ Department of Epidemiology, University of Washington, Seattle, Washington
⁵ Cardiovascular Health Research Unit, VA Puget Sound Health Care System, Seattle, Washington
⁶ Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington

Address correspondence and reprint requests to Darcy B. Carr, MD, MS, Box 356460, University of Washington, Seattle, WA 98195-6460. E-mail:darcarr{at}u.washington.edu

OBJECTIVE— We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with first-degree relatives with type 2 diabetes.

RESEARCH DESIGN AND METHODS— Women with (n = 332) and without (n = 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD.

RESULTS— Women with prior GDM were younger (48.6 ± 0.7 vs. 52.4 ± 0.6 years [means ± SE];P < 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P < 0.005). Although both groups were obese (BMI 34.4 ± 1.2 vs. 33.7 ± 0.6 kg/m²), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P < 0.001) and type 2 diabetes (93.4 vs. 63.3%; P < 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21–2.82];P = 0.005) that occurred at a younger age (45.5 ± 2.2 vs. 52.5 ± 1.9 years;P = 0.02) and was independent of metabolic syndrome (1.74 [1.10–2.76]; P = 0.02) and type 2 diabetes (1.56 [1.002–2.43];P < 0.05).

CONCLUSIONS— Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.

Abbreviations: CVD, cardiovascular disease • GENNID, GENetics of Non-Insulin dependent Diabetes • GDM, gestational diabetes mellitus

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