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Pregnancy disorders elevate risk of future diabetes

Two conditions that commonly occur during pregnancy significantly increase the risk of future diabetes in women, according to a large Canadian study published online in the journal PLoS Medicine .
Researchers from the University of Toronto found that pregnant women who develop pre-eclampsia and gestational hypertension could be twice as likely to develop diabetes later in life than women who do not suffer these pregnancy complications, indicating that the two disorders may be new risk factors for diabetes in women.
Pre-eclampsia is a condition where pregnant women develop high blood pressure, fluid retention and protein in urine, while gestational hypertension is high blood pressure associated with pregnancy.
Using data from a comprehensive Canadian health database, endocrinologist Denice Feig and colleagues identified over 1 million pregnant women delivering between April 1994 and March 2008 in an Ontario hospital who had pre-eclampsia, gestational hypertensio, gestational diabetes (already a known risk factor for later diabetes), or a combination of these conditions.
During follow-up (180 days after giving birth until March 2011), they noted that 35,077 women developed diabetes (3.5%).
Their analysis showed the risk of future diabetes was 1.95 times greater in women with gestational hypertension alone, 2.08 times higher in women with pre-eclampsia alone, and 12.77 times higher in women with gestational diabetes alone.
But after combining gestational diabetes with the other two condition, they found that the risk grew significantly to 18.49 times higher for gestational hypertension and 15.75 times greater for pre-eclampsia.
They concluded that “the presence of either pre-eclampsia or gestational hypertension during pregnancy were strong predictors for the development of diabetes in the years following the pregnancy”, while the conditions in women with a history of gestational diabetes elevated the risk of diabetes “over and above that observed with gestational diabetes alone.
“A history of preeclampsia or gestational hypertension during pregnancy should alert clinicians to the need for preventative counselling and more vigilant screening for diabetes,” they added.

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