Treating Type 2 Diabetes: Looking Ahead - Episode 11

Gestational Diabetes and Cardiovascular Disease Risk

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Guidance in terms of counseling women on pregnancy, gestational diabetes, and the risk for cardiovascular events.

Margo B. Minissian, PhD, ACNP: One other group Davida that I just wanted to touch on quickly, I would be remiss without mentioning it, are our gestational diabetics. I direct the postpartum heart health program where we do a lot of very high-level cardiovascular prevention. I see a lot of postpartum hypertension that often times is uncontrolled. With these young women coming back in through the emergency department in hypertensive crisis, many of them have gestational diabetes. It’s linked hand in hand for preeclampsia and type 2 diabetes. Their future risk of cardiovascular disease is profoundly higher than anyone else if they were a gestational diabetic. It leads to type 2 diabetes. It’s sort of a crystal ball into their heart health and their cardiovascular health. I just want to remind those that if you have a female patient ask her about her pregnancy history and if she had preeclampsia or preterm delivery or if she had a baby that was too small or if she was a gestational diabetic, she needs intensive therapy. Because if 1 of 3 or 4 women are going to die of heart disease, it’s typically that woman who had that adverse pregnancy outcome. We can intervene so much earlier now than we’ve ever have been able to before.

Davida Kruger, NP: And if you think about that woman, they’re no longer seeing endocrinology because we took care of it during the pregnancy. They’re not seeing a high-risk OB [obstetrician] anymore because they took care of that during the pregnancy. We have to urge people in primary care to ask that history to make sure that they’re aggressive so that these women do not fall through any of those loops.

Margo B. Minissian, PhD, ACNP: They get labeled normal again as soon as they deliver. That’s a huge risk.

Davida Kruger, NP: I want to thank our audience for watching HCPLive® Peers and Perspectives. If you enjoyed the content, please subscribe for our new e-newsletter to receive upcoming Peers and Perspectives and other great content right in your inbox. I receive it and I really love it when I see it in there. Take some time to enjoy it. Thank you again for joining us.

Transcript edited for clarity.