ArticleDiabetes, obesity & metabolism2026
Associations between gestational diabetes and cardiovascular disease largely operate independently of postpartum causal pathways: A population-based cohort study in England.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- A three-metabolite microbiota-associated signature for early risk stratification of gestational diabetes mellitus.Cardiovascular diabetology · 2026Article
- Associations between gestational diabetes and cardiovascular disease largely operate independently of postpartum causal pathways: A population-based cohort study in England.Diabetes, obesity & metabolism · 2026Article
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5 authors.
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Abstract
backgroundGestational diabetes mellitus (GDM) is associated with increased risk of developing type 2 diabetes and cardiovascular disease (CVD). Here we explore whether the associations are mediated by development of type 2 diabetes and other CVD risk factors.
methodsThe Exploring Long-term Outcomes following PrEgnancy affected by GDM (ELOPE-GDM) study is a population-based matched cohort study, containing 43 572 records of women diagnosed with GDM matched with 174 288 records of non-GDM women. We used Cox proportional hazards models to assess the risk of GDM on CVD, ischemic heart disease (IHD) and stroke/TIA and quantified the proportions of these effects mediated by the progression to type 2 diabetes, hypertension or dyslipidaemia using causal mediation analysis.
resultsThere were significant associations between GDM and CVD; (adjusted HR 1.58 (95% CI 1.27-1.97)), IHD (1.83 (1.35-2.49)) and stroke/TIA (1.43 (1.06-1.95)). There were strong associations between GDM and developing type 2 diabetes (OR 13.90 (95% CI 13.19-14.51)), hypertension (1.87 (1.781-1.92)), dyslipidaemia (1.80 (1.76-1.84)) or any of these postpartum mediators (1.67 (1.63-1.71)). However, most of the effect of GDM on CVD was not attributed to the overall mediating effects of type 2 diabetes (36% (95% CI 8%-64%)), hypertension (15% (5%-24%)), dyslipidaemia (37% (18%-55%)) or a combination of these conditions (32% (11%-53%)) which developed after pregnancy.
conclusionThese findings emphasise the need for comprehensive cardio metabolic screening following a pregnancy affected by GDM.
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