Women with type 1 diabetes (T1D) are at higher risk for Gestational Hypertensive Disorders (GHD) and cardiovascular disease (CVD) compared to women without diabetes. However, the long-term consequences of GHD complicated by T1D on CVD are unknown. We compared CVD risk factors pre-pregnancy (median follow-up 3 years, IQR 2-4 years) to post-pregnancy (median 2 years, IQR 1-3 years) excluding six weeks post-partum in women with T1D with a first pregnancy complicated by GHD (n=27) vs. those with an uncomplicated pregnancy (n=49), frequency matched for age (mean age 25 years) and diabetes duration (mean duration 12 years). Linear mixed models adjusted for age, diabetes duration, and weeks gestation were used to examine CVD risk factors. Pre-pregnancy, the groups did not differ in age, diabetes duration, body mass index (BMI), lipids, systolic or diastolic blood pressure (BP) (Table). A1c was higher pre-pregnancy in the complicated vs. uncomplicated group (p=0.004); post-pregnancy there was no change in the complicated group but an increase in A1c in the uncomplicated group (p=0.003). Complicated pregnancies resulted in increased systolic (p=0.001) and diastolic BP (p=0.01) post-pregnancy; uncomplicated pregnancies were not associated with significant changes in BP. Women with T1D and a pregnancy complicated by GHD had similar BP but higher A1c pre-pregnancy, and persistently higher BP post-pregnancy, suggesting a need to intervene to prevent CVD.
J.K. Snell-Bergeon: None. L. Pyle: None. R.M. Sippl: None. S. Polsky: Consultant; Self; Jaeb Center for Health Research. Research Support; Self; Barbara Davis Center for Diabetes, Children's Diabetes Foundation, Dexcom, Inc., Eli Lilly and Company, JDRF, Leona & Harry Helmsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, Sanofi US.
American Diabetes Association (7-13-CD-10 to J.K.S-B.)