Impact of prior gestational diabetes on long-term type 2 diabetes complications

J Diabetes Complications. 2022 Sep;36(9):108282. doi: 10.1016/j.jdiacomp.2022.108282. Epub 2022 Aug 2.

Abstract

Aims: While women with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes mellitus (T2DM) and at a younger age, it is unknown whether T2DM following GDM is associated with worse clinical outcomes. This study aims to examine the impact of GDM on subsequent development of long-term complications of T2DM.

Methods: All women with T2DM from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of US population, between 2007 and 2018 (n = 2494) were stratified into two groups: those with a history of GDM (n = 385) and those without (n = 2109). Rates of macrovascular and microvascular complications of T2DM were compared between the two groups using bivariate and multivariate analyses.

Results: Of 2494 participants with T2DM included in the analysis, 385 (15.4 %) had a history of GDM and 2109 (84.6 %) did not. A history of GDM was independently associated with increased risk of myocardial infarction (aOR 2.53, 95%Cl: 1.18-5.40) and likely coronary artery disease (aOR 2.15, 95 % Cl: 1.00-4.66).

Conclusions: In this cohort, women with T2DM and a history of GDM had higher risk of macrovascular complications of myocardial infarction and coronary artery disease, compared to those with no history of gestational diabetes.

Keywords: CAD; GDM; Macrovascular; Myocardial infarction; T2DM.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Coronary Artery Disease* / complications
  • Cross-Sectional Studies
  • Diabetes Complications* / complications
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes, Gestational* / diagnosis
  • Diabetes, Gestational* / epidemiology
  • Female
  • Humans
  • Myocardial Infarction* / complications
  • Nutrition Surveys
  • Pregnancy
  • Risk Factors