Caroline K. Kramer, Sara Campbell, Ravi Retnakaran
A series of recent studies has suggested that women who develop gestational diabetes (GDM) have an increased future risk of cardiovascular disease (CVD). However, these studies have yielded varying estimates of the magnitude of risk and offered conflicting evidence on whether this risk is dependent upon the development of type 2 diabetes. In a meta-analysis involving more than 5 million women, Kramer et al (https://doi.org/10.1007/s00125-019-4840-2) report three key findings. First, compared with women who did not have GDM, women with GDM had a twofold higher risk of major cardiovascular events in the years thereafter. Second, this risk was not dependent on the development of intercurrent type 2 diabetes. Third, the risk of CVD in women with GDM was evident as early as the first decade after delivery. Thus, with or without subsequent type 2 diabetes, the diagnosis of GDM should be recognised as a risk factor for future CVD and, hence, an opportunity for early risk modification and, possibly, prevention of the leading cause of mortality in women.