Gestational diabetes and the long-term risk of cataract surgery: A longitudinal cohort study

Abstract

Aims: We assessed the long-term risk of cataract following a pregnancy complicated by gestational diabetes.

Methods: We carried out a longitudinal cohort study of 1,108,541 women who delivered infants between 1989-2013 in Quebec, Canada, with follow-up extending up to 25years later. The cohort included 71,862 women with gestational diabetes and 5247 with cataracts. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of gestational diabetes with subsequent risk of cataract, adjusted for age, parity, socioeconomic status, time period, comorbidity, and type 2 diabetes.

Results: Women with gestational diabetes had an elevated incidence of cataract (22.6 per 1000) compared with no gestational diabetes (15.1 per 1000), with 1.15 times the risk (95% CI 1.04-1.28). Women with gestational diabetes who subsequently developed type 2 diabetes had a higher risk of cataract compared with no gestational and type 2 diabetes (HR 3.62, 95% CI 3.01-4.35), but women with gestational diabetes who did not develop type 2 diabetes continued to be at risk (HR 1.12, 95% CI 1.00-1.25).

Conclusions: Gestational diabetes may be an independent risk factor for cataract later in life, although risks are greatest for women who subsequently develop type 2 diabetes.

Keywords: Cataract; Diabetes mellitus, type 2; Diabetes, gestational; Longitudinal studies; Ophthalmology; Pregnancy.