New Gestational Diabetes Review Emphasizes Post-Partum Endothelial Function

A new review, published on March 12 in the Journal of the American College of Cardiology, examines the underlying causes of gestational diabetes and mild forms of dysglycemia during pregnancy and how such conditions may contribute to the subsequent development of type 2 diabetes and cardiovascular disease.

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In the article, lead author Shireen Brewster, MD, BS, Mount Sinai Hospital Department of Medicine, University of Toronto, Canada, and colleagues write that gestational diabetes and other forms of dysglycemia occurring during pregnancy predispose women to a subsequent increased risk of type 2 diabetes, metabolic syndrome, and cardiovascular disease. The authors specifically review data on changes in post-partum endothelial and vascular smooth muscle responsiveness, as well as the potential of biomarkers for identifying long-term cardiovascular risk in post-partum women. These changes become evident in the first few months post-partum.

"Gestational dysglycemia identifies a group of women who are at increased risk not only of type 2 diabetes mellitus, but also an earlier age of onset of cardiovascular disease. The usefulness of identifying a dysglycemic pregnancy is that this will identify a population of women at increased subsequent cardiometabolic risk," the authors write.

"Detection of these conventional abnormalities affords clinicians an opportunity to attenuate such risk by targeted intervention. One goal for future investigation is to identify and validate as potentially useful post-partum screening tools biomarkers of subsequent vascular risk, including altered endothelial responsiveness, that may be evident before diabetes, metabolic syndrome or cardiovascular events emerge," they add.

Keywords: Canada, Diabetes Mellitus, Type 2, Postpartum Period, Risk Factors, Metabolic Syndrome, Diabetes, Gestational, Biomarkers, Cardiovascular Diseases, Hospital Departments, Muscle, Smooth, Vascular, Age of Onset, United States, Pregnancy

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