Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study.

Bibliographic Details
Title: Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study.
Authors: Barbara Daly, Konstantinos A Toulis, Neil Thomas, Krishna Gokhale, James Martin, Jonathan Webber, Deepi Keerthy, Kate Jolly, Ponnusamy Saravanan, Krishnarajah Nirantharakumar
Source: PLoS Medicine, Vol 15, Iss 1, p e1002488 (2018)
Publisher Information: Public Library of Science (PLoS), 2018.
Publication Year: 2018
Collection: LCC:Medicine
Subject Terms: Medicine
More Details: BackgroundGestational diabetes mellitus (GDM) is associated with developing type 2 diabetes, but very few studies have examined its effect on developing cardiovascular disease.Methods and findingsWe conducted a retrospective cohort study utilizing a large primary care database in the United Kingdom. From 1 February 1990 to 15 May 2016, 9,118 women diagnosed with GDM were identified and randomly matched with 37,281 control women by age and timing of pregnancy (up to 3 months). Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated for cardiovascular risk factors and cardiovascular disease. Women with GDM were more likely to develop type 2 diabetes (IRR = 21.96; 95% CI 18.31-26.34) and hypertension (IRR = 1.85; 95% CI 1.59-2.16) after adjusting for age, Townsend (deprivation) quintile, body mass index, and smoking. For ischemic heart disease (IHD), the IRR was 2.78 (95% CI 1.37-5.66), and for cerebrovascular disease 0.95 (95% CI 0.51-1.77; p-value = 0.87), after adjusting for the above covariates and lipid-lowering medication and hypertension at baseline. Follow-up screening for type 2 diabetes and cardiovascular risk factors was poor. Limitations include potential selective documentation of severe GDM for women in primary care, higher surveillance for outcomes in women diagnosed with GDM than control women, and a short median follow-up postpartum period, with a small number of outcomes for IHD and cerebrovascular disease.ConclusionsWomen diagnosed with GDM were at very high risk of developing type 2 diabetes and had a significantly increased incidence of hypertension and IHD. Identifying this group of women in general practice and targeting cardiovascular risk factors could improve long-term outcomes.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1549-1277
1549-1676
Relation: https://doaj.org/toc/1549-1277; https://doaj.org/toc/1549-1676
DOI: 10.1371/journal.pmed.1002488
Access URL: https://doaj.org/article/43eaa596872843fbab6a0b61d71d329c
Accession Number: edsdoj.43eaa596872843fbab6a0b61d71d329c
Database: Directory of Open Access Journals
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More Details
ISSN:15491277
15491676
DOI:10.1371/journal.pmed.1002488
Published in:PLoS Medicine
Language:English