Diabetes is a chronic metabolic disease that affects the way our bodies use digested food for energy.

According to the World Health Organization, the prevalence of diabetes has been steadily increasing since 1980, and in 2014, 8.5% of adults over the age of 18 years worldwide had diabetes (WHO, 2016). Women with diabetes who become pregnant are at increased risk for maternal and fetal complications.

One such complication is cardiovascular disease (CVD) which poses a significant threat to maternal health during pregnancy and long-term health after pregnancy. In this article, we will explore the relationship between maternal diabetes and cardiovascular risk.

The Association between Diabetes and Cardiovascular Disease

Diabetes is considered a major risk factor for the development of cardiovascular disease. Adults with diabetes are two to four times more likely to have heart disease or a stroke than people without diabetes (ADA, 2018).

The mechanisms that contribute to this increased risk are complex and multifactorial. Individuals with diabetes have an increased risk of developing atherosclerosis which is a hardening and narrowing of the arteries due to the accumulation of plaque.

This plaque buildup can cause blockages in the heart or brain, leading to heart attacks or strokes.

Maternal Diabetes and Cardiovascular Risk

Maternal diabetes is known to have an adverse impact on both maternal and fetal health outcomes. Women with diabetes are at a significantly higher risk of developing cardiovascular disease compared to women without diabetes. A study by Bellamy et al.

(2009) found that women with pre-existing diabetes or gestational diabetes had an increased risk of developing hypertension, preeclampsia, and venous thromboembolism compared to women without diabetes. This study also found that women with gestational diabetes were at an increased risk of developing type 2 diabetes later in life, further increasing their risk of cardiovascular disease.

Hypertension in Maternal Diabetes

Hypertension is a common complication of maternal diabetes and is a significant risk factor for the development of cardiovascular disease.

Hypertension is defined as a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher. Women with diabetes are up to four times more likely to develop hypertension during pregnancy compared to women without diabetes (ADA, 2018).

Studies have shown that hypertension in pregnancy is associated with an increased risk of hypertension later in life, as well as an increased risk of cardiovascular disease (Fretts et al., 1995).

Preeclampsia in Maternal Diabetes

Preeclampsia is a pregnancy complication characterized by high blood pressure and damage to one or more organ systems, most commonly the liver and kidneys.

Women with pre-existing diabetes or gestational diabetes are at an increased risk of developing preeclampsia compared to women without diabetes. A study by Walden et al. (2001) found that women with pre-existing diabetes were at a five-fold increased risk of developing preeclampsia, and women with gestational diabetes were at a two-fold increased risk compared to women without diabetes.

Preeclampsia is associated with an increased risk of cardiovascular disease later in life, particularly for women who experience preeclampsia in their first pregnancy (Bellamy et al., 2009).

Gestational Diabetes and Cardiovascular Risk

Gestational diabetes is a form of diabetes that develops during pregnancy and is characterized by high blood sugar levels.

Women with gestational diabetes are at an increased risk of developing type 2 diabetes later in life, which increases their long-term risk of cardiovascular disease. A study by Damm et al. (2016) found that women with gestational diabetes had an increased risk of developing type 2 diabetes, hypertension, and dyslipidemia over a ten-year follow-up period compared to women without gestational diabetes.

This study highlights the importance of postpartum follow-up and screening for women with a history of gestational diabetes to prevent the development of long-term cardiovascular complications.

Breastfeeding and Cardiovascular Risk

Breastfeeding has been shown to have protective effects against the development of cardiovascular disease in women with a history of diabetes. A study by Gunderson et al.

(2018) found that women with a history of gestational diabetes who breastfed for six months or longer had a significantly lower risk of developing cardiovascular disease compared to women with a history of gestational diabetes who did not breastfeed or breastfed for a shorter duration. Breastfeeding may have protective effects on cardiovascular health through its ability to improve insulin sensitivity, reduce inflammation, and improve lipid metabolism.

Conclusion

Maternal diabetes is associated with an increased risk of cardiovascular disease for women both during and after pregnancy.

Women with diabetes are at an increased risk of developing hypertension, preeclampsia, and dyslipidemia during pregnancy, which can lead to long-term cardiovascular complications. Gestational diabetes is a particularly important risk factor for the development of type 2 diabetes and cardiovascular disease later in life.

Breastfeeding may have protective effects against the development of cardiovascular disease in women with diabetes. Early identification and management of diabetes in pregnancy, as well as postpartum follow-up and screening, are crucial for the prevention of long-term cardiovascular complications in women with diabetes.