Gestational diabetes in pregnant women may be an early risk factor of heart disease, apparent before full blown diabetes or other metabolic diseases show up later in the mother’s life, according to a study released Wednesday. 

Gestational diabetes develops during pregnancy and usually disappears afterwards, but it increases the risk of later diabetes. The condition is managed by changing the diet and activity and sometimes adding insulin or other medications.

The study points out the need for doctors to monitor patients with gestational diabetes after they give birth to help prevent atherosclerosis — the buildup of plaque in the arteries that can lead to heart attack and stroke, said researchers.

“Pregnancy has been under-recognized as an important time period that can signal a woman’s greater risk for future heart disease. This signal is revealed by gestational diabetes, a condition of elevated blood sugar during pregnancy,” said Erica P. Gunderson, Ph.D., M.S., M.P.H., study lead author and senior research scientist in the Division of Research at Kaiser Permanente Northern California in Oakland, Calif.

Researchers measured heart disease risk factors in 898 women, ages 18-to-30-years old who did not have heart disease or diabetes before the study. They started before pregnancy and continued after they gave birth. The women were periodically tested for diabetes and metabolic conditions.

They found that 119 women, or 13 percent, developed gestational diabetes.

Researchers took measurements of carotid artery wall thickness using ultrasound imaging an average of 12 years after pregnancy. This is an early measure of early atherosclerosis.

Among the women who did not develop diabetes or the metabolic syndrome during the 20-year follow up, they found a 0.023 mm larger average carotid artery intima-media thickness in those who had gestational diabetes compared to those who didn’t. The difference was not attributed to obesity or elevated glucose before pregnancy.

At the end of the study, 13 women had cardiovascular events, one of whom had gestational diabetes.

The study controlled for age, race, number of births, pre-pregnancy body mass index, fasting blood glucose, insulin, lipids and blood pressure.

Currently, there are no uniform national recommendations for screening for heart disease risk factors in pregnancy to determine risk of later heart disease, Gunderson said.

The article was published online in the Journal of the American Heart Association.

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