Madeline C. Pearson, Huan Wang, Colin E. Murdoch, Alexander S. F. Doney
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Cox regression models assessed how a PE history influenced the risk of future microvascular complications following T2D diagnosis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total, 6055 women were eligible: 726 (12%) had a PE-pregnancy and 5329 (88%) had only PE-free pregnancies, with ~20 years between pregnancy and T2D diagnosis. At T2D diagnosis, women with a PE history had higher BMI (38.3 kg/m<sup>2</sup> vs. 35.7 kg/m<sup>2</sup>, <i>p</i> < 0.001), higher SBP (139 mmHg vs. 135 mmHg, <i>p</i> < 0.001), lower HDL cholesterol (1.18 mmol/L vs. 1.21 mmol/L, <i>p</i> = 0.002) and were diagnosed 3.2 years earlier (<i>p</i> < 0.001). A PE history was associated with increased microvascular disease risk (HR 1.26 95% CI 1.12–1.42, <i>p</i> < 0.001): diabetic retinopathy (HR 1.22 95% CI 1.07–1.38, <i>p</i> = 0.003); chronic kidney disease (HR 1.35 95% CI 1.06–1.71, <i>p</i> = 0.016); diabetic proteinuric kidney disease (HR 2.45 95% CI 1.03–5.81, <i>p</i> < 0.001). Women with a PE history were ~5 years younger when they developed cardiovascular disease (55.7 years vs. 60.6 years, <i>p</i> < 0.001) and all-cause death (60.1 years vs. 65.6 years, <i>p</i> < 0.0001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>At T2D diagnosis, women with a PE history are younger, with more severe clinical presentations and increased risk of developing T2D microvascular complications. This highlights the crucial need for changes to the long-term care of this high-risk group, with aggressive risk-factor management and continued clinical assessment.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70046","citationCount":"0","resultStr":"{\"title\":\"Clinical implications of a history of pre-eclampsia in women with type two diabetes mellitus\",\"authors\":\"Madeline C. Pearson, Huan Wang, Colin E. Murdoch, Alexander S. F. Doney\",\"doi\":\"10.1111/dme.70046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>The consequences of pre-eclampsia (PE) are not limited to pregnancy; a single episode predisposes mothers to serious future health outcomes. Little is known about how PE impacts the course of type 2 diabetes (T2D) and associated microvascular diseases.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The Scottish Care Information for Diabetes data for individuals with diabetes in NHS Tayside and Fife was linked with Scottish maternity morbidity records. A nested case–control study compared BMI, HDL cholesterol, systolic blood pressure(SBP) and HbA1c measures at T2D diagnosis between women with prior pregnancies from 1921 to 2022 affected or unaffected by PE using linear regression and adjusted for the other aforementioned variables. Cox regression models assessed how a PE history influenced the risk of future microvascular complications following T2D diagnosis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In total, 6055 women were eligible: 726 (12%) had a PE-pregnancy and 5329 (88%) had only PE-free pregnancies, with ~20 years between pregnancy and T2D diagnosis. At T2D diagnosis, women with a PE history had higher BMI (38.3 kg/m<sup>2</sup> vs. 35.7 kg/m<sup>2</sup>, <i>p</i> < 0.001), higher SBP (139 mmHg vs. 135 mmHg, <i>p</i> < 0.001), lower HDL cholesterol (1.18 mmol/L vs. 1.21 mmol/L, <i>p</i> = 0.002) and were diagnosed 3.2 years earlier (<i>p</i> < 0.001). A PE history was associated with increased microvascular disease risk (HR 1.26 95% CI 1.12–1.42, <i>p</i> < 0.001): diabetic retinopathy (HR 1.22 95% CI 1.07–1.38, <i>p</i> = 0.003); chronic kidney disease (HR 1.35 95% CI 1.06–1.71, <i>p</i> = 0.016); diabetic proteinuric kidney disease (HR 2.45 95% CI 1.03–5.81, <i>p</i> < 0.001). Women with a PE history were ~5 years younger when they developed cardiovascular disease (55.7 years vs. 60.6 years, <i>p</i> < 0.001) and all-cause death (60.1 years vs. 65.6 years, <i>p</i> < 0.0001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>At T2D diagnosis, women with a PE history are younger, with more severe clinical presentations and increased risk of developing T2D microvascular complications. 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引用次数: 0
摘要
目的：先兆子痫（PE）的后果不仅限于妊娠；一次发作就会使母亲在未来产生严重的健康后果。关于PE如何影响2型糖尿病（T2D）及相关微血管疾病的病程，我们知之甚少。方法：苏格兰护理信息的糖尿病数据的个人与NHS泰赛德和法夫糖尿病与苏格兰产妇发病率记录相关联。一项嵌套病例对照研究比较了1921年至2022年妊娠期间受PE影响或未受PE影响的女性的BMI、高密度脂蛋白胆固醇、收缩压（SBP）和糖化血红蛋白（HbA1c）在T2D诊断中的测量，采用线性回归并对上述其他变量进行了调整。Cox回归模型评估PE病史如何影响T2D诊断后未来微血管并发症的风险。结果：共有6055名妇女入选，其中726例（12%）为pe妊娠，5329例（88%）为无pe妊娠，从妊娠到诊断为T2D间隔约20年。在T2D诊断中，有PE病史的女性BMI更高（38.3 kg/m2 vs. 35.7 kg/m2）， p结论：在T2D诊断中，有PE病史的女性更年轻，临床表现更严重，发生T2D微血管并发症的风险更高。这突出了改变这一高危群体的长期护理的关键需要，包括积极的风险因素管理和持续的临床评估。
Clinical implications of a history of pre-eclampsia in women with type two diabetes mellitus
Aims
The consequences of pre-eclampsia (PE) are not limited to pregnancy; a single episode predisposes mothers to serious future health outcomes. Little is known about how PE impacts the course of type 2 diabetes (T2D) and associated microvascular diseases.
Methods
The Scottish Care Information for Diabetes data for individuals with diabetes in NHS Tayside and Fife was linked with Scottish maternity morbidity records. A nested case–control study compared BMI, HDL cholesterol, systolic blood pressure(SBP) and HbA1c measures at T2D diagnosis between women with prior pregnancies from 1921 to 2022 affected or unaffected by PE using linear regression and adjusted for the other aforementioned variables. Cox regression models assessed how a PE history influenced the risk of future microvascular complications following T2D diagnosis.
Results
In total, 6055 women were eligible: 726 (12%) had a PE-pregnancy and 5329 (88%) had only PE-free pregnancies, with ~20 years between pregnancy and T2D diagnosis. At T2D diagnosis, women with a PE history had higher BMI (38.3 kg/m2 vs. 35.7 kg/m2, p < 0.001), higher SBP (139 mmHg vs. 135 mmHg, p < 0.001), lower HDL cholesterol (1.18 mmol/L vs. 1.21 mmol/L, p = 0.002) and were diagnosed 3.2 years earlier (p < 0.001). A PE history was associated with increased microvascular disease risk (HR 1.26 95% CI 1.12–1.42, p < 0.001): diabetic retinopathy (HR 1.22 95% CI 1.07–1.38, p = 0.003); chronic kidney disease (HR 1.35 95% CI 1.06–1.71, p = 0.016); diabetic proteinuric kidney disease (HR 2.45 95% CI 1.03–5.81, p < 0.001). Women with a PE history were ~5 years younger when they developed cardiovascular disease (55.7 years vs. 60.6 years, p < 0.001) and all-cause death (60.1 years vs. 65.6 years, p < 0.0001).
Conclusions
At T2D diagnosis, women with a PE history are younger, with more severe clinical presentations and increased risk of developing T2D microvascular complications. This highlights the crucial need for changes to the long-term care of this high-risk group, with aggressive risk-factor management and continued clinical assessment.
期刊介绍：
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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