Gestational diabetes increases your long-term risk of heart disease

Women with gestational diabetes are being warned that, if they don’t improve their health, diet and lifestyle after pregnancy, the condition could increase significantly their risk of heart disease and hypertension over the course of their life.

Women with gestational diabetes may have to manage their diet and lifestyle much longer than during pregnancy. Source: Getty

The impact of gestational diabetes on a woman’s health, diet and lifestyle routines could last much longer than the nine months of their pregnancy, according to new research.

A New Zealand-led study, published in the journal PLOS Medicine today, shows that women who experience gestational diabetes mellitus (GDM) are twice as likely to develop a form of heart disease or hypertension later in life than women who don’t experience the condition during pregnancy.

Although women with GDM are at a higher risk of getting it again with their next pregnancy, it's been thought that when the pregnancy is over, the diabetes usually disappears: only two out of 100 women who experience GDM will continue to have diabetes after their baby is born.

However, this study puts forward new evidence that women with GDM will be 20 times more likely to develop type 2 diabetes for up to 25 years after their pregnancy ends.

“While the condition, which occurs during pregnancy, only lasts for the duration of a pregnancy its impacts can be felt for a lifetime and across generations,” Associate Professor Greg Johnson, Diabetes Australia CEO, tells SBS.

“Gestational diabetes is the fastest growing type of diabetes in Australia with the number of women being diagnosed annually more than doubling over the past decade. 

“In 2016-17, more than 37,000 Australian women were diagnosed with the condition. Projections show that over the next decade more than 500,000 Australian women could develop the condition.”

While the condition, which occurs during pregnancy, only lasts for the duration of a pregnancy its impacts can be felt for a lifetime and across generations.

Gestational diabetes occurs during pregnancy when a woman’s body cannot cope with the extra demand for insulin production. It results in high blood glucose levels.

Diabetes Australia warns that women from an Indigenous Australian, Torres Strait Islander, Vietnamese, Chinese, Middle Eastern, Polynesian or Melanesian background are at risk of developing GDM. Females aged over 25 years who are overweight or have a family history of type 2 diabetes are also at risk.

The importance of diet and lifestyle changes

Women with GDM are typically advised to adopt a healthy eating and exercise plan during the course of their pregnancy to avoid complications to their or the baby’s health.

An optimal diet for someone with the condition should include small amounts of carbohydrates in every meal and snack, and foods that are high in fibre or have a low glycaemic index. Women are also encouraged to eat small amounts often, and avoid foods and drinks with large amounts of sugar.

An optimal diet for someone with the condition should include small amounts of carbohydrates in every meal and snack, and foods that are high in fibre or have a low glycaemic index.

The findings from this new study suggests that females may have to pay greater attention to controlling their weight and altering their diet after pregnancy to counteract their increased risk of getting type 2 diabetes, hypertension and ischaemic heart disease later in life.

A/Professor Johnson says it’s also vital that women with GDM get the support they need so that the long-term cycle of type 2 diabetes can be disrupted.

“This includes access to a credentialed diabetes educator and expert advice on diet and physical activity. And we need to provide post-GDM education and support to reduce a mother and her child’s risk of developing type 2 diabetes later in life.”

The study used a large UK database including over 9,000 women who had been diagnosed with GDM between 1990 and 2016. It compared their health with over 37,000 women who were the same age and pregnant over a similar time period who did not develop the condition.

Most of the women in the study with GDM were overweight with a BMI of 25 and above. The average age of the women with GDM at the time that each woman gave birth was 33 years and ranged from 14 to 47 years.

The increased risk persisted throughout the 25-year follow-up period. Follow-up screening for type 2 diabetes was poor with less than 60 percent of women with GDM undergoing screening in the early post-partum period and had decreased to less than 40 percent by the second year.