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Diabetes

GDM associated with higher later diabetes and heart risks

Daly B, Toulis KA, Thomas N, et al. · PLoS medicine · 2018

Open access · cc by · source: Europe PMC

Women with gestational diabetes had sharply higher later type 2 diabetes risk and elevated hypertension and ischemic heart disease risk versus matched pregnant controls.

Study at a glance

Design
Cohort — UK primary-care records; GDM vs age- and pregnancy-timing-matched controls (up to 4:1)
N
N=9118 · 9,118 women with GDM; control headcount only in sampling-frame figure, not numeric in stored text
Population
Women with gestational diabetes vs matched pregnant controls without GDM
Outcome
Incident type 2 diabetes, hypertension, and ischemic heart disease

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

Among 9,118 women with GDM, adjusted incidence rate ratios showed more than a twenty-fold higher type 2 diabetes risk, nearly two-fold higher hypertension risk, and more than 2.5-fold higher IHD risk, without increased cerebrovascular disease risk. Not all IHD cases occurred after postpartum diabetes.

Methodology

Using UK primary-care electronic records, researchers identified women with gestational diabetes mellitus (GDM) and compared them with age- and pregnancy-timing-matched controls for incident type 2 diabetes, hypertension, ischemic heart disease (IHD), and cerebrovascular disease.

Limitations

Observational coding-based GDM diagnosis can misclassify cases, median follow-up was relatively short, and residual confounding by unmeasured lifestyle factors remains. It does not prove which postpartum interventions best cut cardiovascular risk.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • QualifiesDiabetes Careconcept

    Longer rotating night-shift work associates with higher type 2 diabetes risk in nurses.

    In Nurses’ Health Study I and II, longer rotating night-shift duration was associated with higher incident type 2 diabetes risk (age-adjusted HR about 1.64 and 2.50 for ≥20 years vs never).

    Scope note — different exposure — prior GDM, not night-shift schedules

    Limits the claim's scope: a different population, assay, or outcome.

  • SupportsDiabetes Careconcept

    Gestational diabetes marks markedly higher later type 2 diabetes risk in linked records.

    Among women with gestational diabetes in linked records, adjusted rates showed markedly higher later type 2 diabetes risk and elevated hypertension and ischemic heart disease risks versus comparison women.

    Evidence for the claim as stated.

  • SupportsDiabetes Careconcept

    Muscle mechanism studies, night-shift incidence, GDM sequelae, T2D complication associations, and a T1D app trial all sit under diabetes care but answer different estimands. They are complementary scopes, not interchangeable results.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-14

    Removed as supporting evidence on Diabetes Care

    In human muscle physiology work, TXNIP is reciprocally regulated by insulin and glucose, elevated in T2DM/prediabetes, and inversely related to glucose uptake—pointing to a molecular brake on peripheral glucose disposal.

  2. 2026-09-14

    Placed as a scope qualifier on Diabetes Care

    In Nurses’ Health Study I and II, longer rotating night-shift duration was associated with higher incident type 2 diabetes risk (age-adjusted HR about 1.64 and 2.50 for ≥20 years vs never).

  3. 2026-09-14

    Placed as supporting evidence on Diabetes Care

    Among women with gestational diabetes in linked records, adjusted rates showed markedly higher later type 2 diabetes risk and elevated hypertension and ischemic heart disease risks versus comparison women.

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