Erica P. Gunderson, PhD, MS, MPH: The Risks of Gestational Diabetes

While drivers of gestational diabetes are not fully evidenced, data shows how it's linked to great likelihood of type 2 diabetes and cardiovascular events.

The exact definition of gestational diabetes lends to its role as an indicator of possible cardiometabolic risks that a woman may later face: it is simply glucose intolerance that is first recognized at pregnancy.

Though it’s often resolved in diagnosed women, predominately with diet and exercise changes, it’s become understood that gestational diabetes could be a harbinger of greater disease risks.

In an interview with HCPLive during The Metabolic Institute of America’s (TMIOA) 2021 Heart in Diabetes sessions in New York, NY this weekend, Erica P. Gunderson, PhD, MS, MPH, Senior Research Scientist, Kaiser Permanente Northern California Division of Research, discussed the common misinterpretation of newly diagnosed gestational diabetes.

“That doesn’t mean that women didn’t have some type of dismetabolism before pregnancy,” Gunderson explained. “But there’s so few studies that measure those cardiometaboloic risk factors before pregnancy or after pregnancy.”

Gunderson explained the risk of variability in recovery from gestational diabetes, and the uncertainties of what influences its development and progression in patients. It’s likely a combination of pre-pregnancy risk factors and an exacerbation of metabolic dysfunction brought on by the metabolic demands of a pregnancy, she said.

As Gunderson explained, women with gestational diabetes have an estimated 7-fold increased risk of type 2 diabetes (T2D) development—and anywhere from 20-50% such patients develop T2D within a decade after pregnancy. The questions that remain is its association with cardiovascular event risk—an occurrence which women generally face in their 60s and beyond.

“Gestational diabetes can reveal early risk of subclinical cardiovascular risk that can develop into events later,” she said.