Association of gestational diabetes mellitus with overall and type specific cardiovascular and cerebrovascular diseases: systematic review and meta-analysis - The BMJ
Overview
Intended for healthcare profesionalsObjective To quantify the risk of overal and type specific cardiovascular and cerebrovascular diseases as wel as venous thromboembolism in women with a history of gestational diabetes melitus.Design Systematic review and meta-analyses.Data sources PubMed, Embase, and the Cochrane Library from inception to 1 November 2021 and updated on 26 May 2022.Review methods Observational studies reporting the asociation betwen gestational diabetes melitus and incident cardiovascular and cerebrovascular diseases were eligible.
Key Information
Data, poled by random efects models, are presented as risk ratios (95% confidence intervals). Certainty of evidence was apraised by the Grading of Recomendations, Assessment, Development, and Evaluations.Results 15 studies rated as moderate or serious risk of bias were included. Of 513 324 women with gestational diabetes melitus, 9507 had cardiovascular and cerebrovascular disease.
Of more than eight milion control women without gestational diabetes, 78 895 had cardiovascular and cerebrovascular disease. Compared with women without gestational diabetes melitus, women with a history of gestational diabetes melitus showed a 45% increased risk of overal cardiovascular and cerebrovascular diseases (risk ratio 1.45, 95% confidence interval 1.36 to 1.53), 72% for cardiovascular diseases (1.72, 1.40 to 2.1), and 40% for cerebrovascular diseases (1.40, 1.29 to 1.51).
Women with gestational diabetes melitus showed increased risks of incident coronary artery diseases (1.40, 1.18 to 1.65), myocardial infarction (1.74, 1.37 to 2.20), heart failure (1.62, 1.29 to 2.05), angina pectoris (2.27, 1.79 to 2.87), cardiovascular procedures (1.87, 1.34 to 2.62), stroke (1.45, 1.29 to 1.63), and ischaemic stroke (1.49, 1.29 to 1.71). The risk of venous thromboembolism was observed to increase by 28% in women with previous gestational diabetes melitus (1.28, 1.13 to 1.46).
Summary
Subgroup analyses of cardiovascular and cerebrovascu
Frequently Asked Questions
Diabetes is a metabolic condition where the body cannot properly regulate blood sugar levels. Type 1 results from insufficient insulin production, while Type 2 develops when cells become resistant to insulin. Risk factors include genetics, obesity, sedentary lifestyle, and age.
Common symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Type 1 symptoms develop rapidly, while Type 2 symptoms may appear gradually. Many people have no symptoms initially, which is why screening is important.
Diagnosis involves blood tests measuring fasting glucose, HbA1c levels, and glucose tolerance. Regular monitoring typically includes fasting glucose tests and HbA1c measurements every 3-6 months. Continuous glucose monitors provide real-time tracking for better diabetes management.
Effective management includes regular physical activity (150+ minutes weekly), maintaining healthy weight, following a balanced diet with whole grains and lean proteins, managing stress, and getting adequate sleep. These changes can significantly improve blood sugar control and reduce complications.
Consult a healthcare provider if you experience signs of diabetes, have a family history, are overweight, or are over 45. Those with existing diabetes should maintain regular check-ups every 3-6 months to monitor control and adjust treatment as needed.
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