Cardiovascular Disease Risk Profiles in Women With Histories of Gestational Diabetes but Without Current Diabetes

Abstract

OBJECTIVE: To compare the cardiovascular disease risk factor profiles of parous women with a history of gestational diabetes who had not developed diabetes, parous women with diagnosed diabetes, and parous women with neither condition. METHODS: We conducted cross-sectional analyses of 4,631 parous women who were not currently pregnant in the Third National Health and Nutrition Examination Survey (1988–1994). Women were classified by self-report as having a history of gestational diabetes who were not currently diabetic (n=85), diagnosed diabetics (n=218), or as having neither condition (n=4,328). We compared these groups with respect to cholesterol subtypes, blood pressure, uric acid, microalbuminuria, insulin, glucose, and clustering of risk factors, before and after adjustment for demographic and behavioral factors and central obesity. RESULTS: In unadjusted comparisons, women who had a history of gestational diabetes who were not currently diabetics had a more favorable or similar risk factor profile compared with unaffected women, with two exceptions: greater levels of mean fasting glucose (94.0 mg/dL compared with 106.8 mg/dL, P<.001) and mean fasting insulin (10.2 international units/L compared with 14.0 international units/L, P<.001). These patterns were attenuated after adjustment for demographic factors and waist circumference, but remained significant for fasting glucose and the ratio of urine microalbumin/creatinine. Parous women with diagnosed diabetes had significantly worse cardiovascular disease risk profiles than unaffected women before and after adjustment. CONCLUSION: Women who had a history of gestational diabetes who were not currently diabetics have a similar cardiovascular disease risk profile to unaffected women, with the exception of insulin and glucose levels. LEVEL OF EVIDENCE: II