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Current Diabetes Reports

, Volume 12, Issue 1, pp 43–52 | Cite as

Gestational Diabetes: Implications for Cardiovascular Health

  • Shannon D. Sullivan
  • Jason G. Umans
  • Robert RatnerEmail author
Diabetes and Pregnancy (CJ Homko, Section Editor)

Abstract

Gestational diabetes mellitus (GDM) is a pregnancy complication that is becoming more prevalent with recent population trends in obesity and advancing maternal age. A diagnosis of GDM not only increases risk for maternal and fetal complications during pregnancy, but also significantly increases a woman’s risk of both type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in the postpartum. Even women with milder forms of abnormal glucose homeostasis during pregnancy, specifically gestational impaired glucose tolerance, are at increased risk, justifying the recent recommendation to tighten the diagnostic criteria for GDM, thus implicating many more women. Risk factors that increase risk for future CVD among women with a history of GDM include postpartum progression to T2DM; metabolic syndrome; obesity; hypertension; and altered levels of circulating inflammatory markers, specifically, adiponectin, C-reactive protein, and tumor necrosis factor-α. Medical therapies such as metformin that prevent progression to T2DM may prove to be our primary defense against earlier CVD among women with GDM.

Keywords

Gestational diabetes Gestational impaired glucose tolerance Cardiovascular disease Metabolic syndrome Type 2 diabetes mellitus Obesity Inflammation 

Clinical Trial Acronyms

DPP

Diabetes Prevention Program

HAPO

Hyperglycemia and Adverse Pregnancy Outcomes

IADPSG

International Association of Diabetes in Pregnancy Study Group

KEEP

Kidney Early Evaluation Program

PIPOD

Pioglitazone in Prevention of Diabetes

TRIPOD

Troglitazone in Prevention of Diabetes.

Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Shannon D. Sullivan
    • 1
  • Jason G. Umans
    • 2
    • 3
  • Robert Ratner
    • 2
    • 3
    Email author
  1. 1.Department of EndocrinologyWashington Hospital CenterWashingtonUSA
  2. 2.Medstar Health Research InstituteHyattesvilleUSA
  3. 3.Georgetown-Howard Universities Center for Clinical and Translational ScienceWashingtonUSA

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