Erica P. Gunderson, PhD, MS, MPH: CARDIA and Improving Screening Guidelines

Women with gestational diabetes face a twice greater risk of developing cardiovascular disease. Investigators are still seeking understanding of the association.

The CARDIA study, published in Circulation earlier this year, was among the first to evidence associations between gestational diabetes in expecting women and longterm cardiovascular risk.

But the understanding of that association is still being investigated.

In the second segment of 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 highlighted the CARDIA study’s influence on understanding gestational diabetes risk progression.

She explained that women who developed gestational diabetes had a 2-fold increased risk of developing coronary artery calcification (CAC) later in life. Most interestingly, such increased risk was regardless of women’s glycemic status prior to gestational diabetes diagnosis: those with normal glycemic levels, prediabetes, or overt incident diabetes faced the same heightened risk of CAC.

Now, Gunderson and colleagues are seeking the underlying risk factors behind CAC development in women with gestational diabetes. “It’s not dysglycemia for these group have normal glycemia, so what are the risk factors that are promoting accumulation of the CAC?” she said.

Improving management of future atherosclerotic disease risk in gestational diabetic women requires more informed recommendations and guidelines than are currently available, Gunderson said.

“And to do that, we need more research in this specific arena as a basis,” she explained.

What remains to be understood, she said, are necessary biomarkers, the frequency by which patients should be screened, and the influence of sociodemographic factors, and clinical factors including obesity and lactation.