Gestational diabetes affects 5 to 9 percent of pregnant women in the United States each year – and its prevalence is increasing. It often disappears on its own after delivery. But recent research suggests it may have lasting effects, increasing the risk of cardiovascular disease later in life.
In this article we explore gestational diabetes and heart disease:
- What this condition is and how it develops
- The link between gestational diabetes and heart disease
- Critical prevention and management strategies to support your cardiovascular and overall health
What is gestational diabetes?
Gestational diabetes is a temporary condition that occurs during pregnancy and affects the way the body processes glucose (sugar). It usually develops during the second or third trimester.
The body releases certain hormones during pregnancy, such as:
- Human placental lactogen (hPL)
- Human Placental Growth Hormone (hPGH)
- Estrogen
- Progesterone
- Cortisol
Although essential for fetal growth, these hormones, when combined with maternal weight gain, can cause insulin resistance – or an inability of the muscle, fat and liver to respond effectively to insulin.
Insulin is a crucial hormone that, when used properly by the body, regulates blood glucose. Gestational diabetes disrupts this process.
Does gestational diabetes go away?
After giving birth, pregnancy hormones drop, which usually reduces insulin resistance. However, many women who develop gestational diabetes have an underlying predisposition to insulin resistance, meaning it will linger and possibly turn into type 2 diabetes.
In addition, some metabolic changes caused by pregnancy may not be completely reversed on their own.
Breastfeeding can support blood sugar levels and insulin balance. But a 2019 study found that 5 percent of women with gestational diabetes still developed type 2 diabetes within six months of giving birth, and 10 percent within one to two years.
Overall, gestational diabetes can cause a seven times higher risk of type 2 diabetes, a condition that is also a major risk factor for heart disease.
The link between gestational diabetes and heart disease
Both gestational diabetes and type 2 diabetes can lead to permanent changes in the blood vessels, which contribute to cardiovascular disease. Some of these changes include:
- High blood sugar causes endothelial (inner endothelium) dysfunction.
vessel wall lining), which is an early sign of atherosclerosis (hardening or thickening of the arteries) - Oxidative stress and low-grade inflammation, which further compromise endothelial function and contribute to plaque formation
- Lower levels of nitric oxide (a critical vasodilator), leading to vascular resistance and high blood pressure
- Decreased blood flow due to these changes, which can potentially cause oxygen deprivation and cell damage in the heart
One study also found that women with a history of gestational diabetes had elevated coronary artery calcium (CAC) levels – a direct marker of plaque in the coronary arteries. As calcium builds up, it narrows the blood vessels, restricting blood flow to the heart.
While a little calcium can help stabilize plaques, too much calcium can make them more likely to rupture. If they do, they can cause blood clots, which can cause serious problems such as heart attacks.
In addition, high blood sugar can disrupt the way the body processes fats, leading to higher cholesterol levels. Gestational diabetes can affect the way your body absorbs cholesterol and develops HDL (the “good” kind).
It is also common for women with this condition to have higher:
- Triglycerides
- Total cholesterol
- LDL (“bad” cholesterol)
These problems contribute to the hardening of the arteries (atherosclerosis).
You may even develop heart problems – especially in the first ten years after giving birth – if your blood sugar levels return to normal after giving birth. Research shows that you will have to deal with:
- 72% greater overall risk of cardiovascular disease
- 40% higher risk of coronary heart disease
- 74% higher risk of heart attack
- 62% higher risk of heart failure
- 45% increased risk of stroke
Risk comparison with other factors
According to some research, gestational diabetes can be as serious as other major cardiovascular risk factors, such as:
- Obesity
- Smoking
- High blood pressure
Some experts even warn that women with a history of gestational diabetes face slightly higher risks than women with a family history of heart disease. Continuous preventive care is therefore essential.
Preventing heart disease after gestational diabetes
Even if you have had gestational diabetes, there are effective steps you can take to protect your heart:
Regular screening and monitoring
Experts recommend getting tested for diabetes 4 to 12 weeks after giving birth, and every 1 to 3 years after that to ensure blood sugar levels stay within a healthy range.
And make it a point to get regular heart health screenings, checking your blood pressure and cholesterol levels.
Lifestyle interventions
Adopting a healthier lifestyle is one of the most powerful ways to lower the risk of cardiovascular disease, especially for women with a history of gestational diabetes.
Eat mostly heart-healthy foods that don’t spike blood sugar, such as:
- Low-glycemic (low-sugar) fruits such as berries, apples and pears
- Non-starchy vegetables, such as broccoli, spinach and peppers
- Whole grains, such as whole wheat, quinoa and oats
- Lean proteins, including chicken and fish
- Healthy fats such as olive oil and avocado
A diet that includes these items helps control blood sugar, blood pressure and cholesterol levels.
You’ll also want to strengthen your heart with regular physical activity, such as:
- To walk
- Misuse
- Strength training
Research confirms that these exercises help improve insulin sensitivity, support weight management and reduce strain on the cardiovascular system, thereby lowering the risk of cardiovascular disease.
Conclusion
Gestational diabetes and heart disease are closely linked, so if you have suffered from high blood sugar during pregnancy, be vigilant about your health.
- Gestational diabetes often goes away after pregnancy, but its impact can be lifelong.
- It can more than double your risk of type 2 diabetes, which itself is a major risk factor for heart disease.
- Insulin resistance and inflammation due to gestational diabetes put pressure on the cardiovascular system.
- Vascular changes can lead to complications such as hypertension.
- It is essential to implement prevention and management strategies such as regular screenings, healthy eating and exercise.
By equipping yourself with knowledge and proactive care, you can protect your cardiovascular system and enjoy a longer, healthier future, regardless of your medical history