Study: Pregnancy diabetes could mean earlier heart disease

diabetes in pregnancy tied to increased heart disease risk
An expecting mother is examined by a midwife during a home visit.

Doctors have known for some time that women who develop pregnancy-related diabetes—known as gestational diabetes—are far more likely to get full-blown Type 2 diabetes years down the road than women who don’t develop the condition when pregnant. But new research suggests that the 2 to 10 percent of pregnant women who get gestational diabetes may also be at a higher risk of getting heart disease decades before those who don’t, which could potentially shorten their lifespan.

In the study published Wednesday in the Journal of the American Heart Association, researchers followed nearly 900 healthy young women for 20 years and found that those who previously had gestational diabetes were more likely to have thickened arteries on an imaging test —an early sign of heart disease—by the time they reached their late 30s to late 40s compared to those who never had the condition.

Women typically develop heart disease in their 60s, about a decade later than men, due to female hormones that protect them through menopause.

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“We found evidence of early heart disease in those who had gestational diabetes even if they weren’t obese or didn’t have Type 2 diabetes,” said study leader Erica Gunderson, a senior research scientist at Kaiser Permanente Northern California in Oakland, Calif. This is the first time researchers found that gestational diabetes is an independent risk factor for heart disease, she added, that could predict future heart attack or stroke risk.

It’s possible that the diabetes, which usually disappears after childbirth, is an early warning sign for future heart problems, but the condition itself might also cause subtle changes in certain hormonal systems, which leads to earlier heart disease.

Regardless of the scientific explanation, Gunderson said doctors should ask women if they’ve ever had pregnancy-related diabetes and should consider closer heart disease monitoring in those who answer yes. Regular blood pressure, blood sugar, and cholesterol screenings are key. Women can also lower their heart disease risk by getting professional help to maintain a healthy weight and active lifestyle. (Most of those who had gestational diabetes are severely overweight.)

While the American Heart Association and other medical groups do not recommend imaging tests to measure artery thickness in women with a history of gestational diabetes, Gunderson said some doctors may want to consider the ultrasound test—called carotid intima media thickness—which is not invasive and fairly routine.