Preeclampsia doubles risk of type 2 diabetes: stepped-up interventions are advocated to improve these women's metabolic and cardiovascular health.(Clinical Rounds)

WASHINGTON -- Women with a history of preeclampsia have a twofold greater risk of developing subsequent type 2 diabetes--even in the absence of gestational diabetes--than do women without a history of the complication, reported Dr. Darcy B. Carr at the annual scientific sessions of the American Diabetes Association.

After presenting findings from a retrospective cohort study of more than 25,000 patients at the Group Health Cooperative in Seattle, Dr. Carr urged her audience to "increase surveillance" of these women and step up interventions to improve their metabolic and cardiovascular health.

It is known that women who develop preeclampsia are more likely to be obese, have a family history of diabetes and cardiovascular disease, and develop future hypertension and cardiovascular disease. They also tend to have a metabolic phenotype--decreased insulin sensitivity, for instance, and dyslipidemia--that increases the risk of developing type 2 diabetes, she said.

Still, "most people don't consider preeclampsia a risk factor for diabetes," said Dr. Carr, of the division of maternal-fetal medicine at the University of Washington, Seattle.

She and her colleagues looked at women who delivered at the Group Health Cooperative between 1985 and 2002 after having been enrolled in the consumer-owned nonprofit health care system for at least a year. They followed the women, each of whom ...