Gestational Diabetes: A Hidden Risk Factor for Midlife Cognitive Decline
Emerging research has uncovered a concerning link between gestational diabetes mellitus (GDM) and cognitive function in midlife. GDM, a form of diabetes that develops during pregnancy, affects how the body processes glucose and typically resolves after childbirth. However, its implications may extend far beyond pregnancy. Recent findings suggest that women with a history of GDM may experience subtle yet significant declines in cognitive abilities, such as memory and executive function, as they reach midlife.
The study analyzed data from a diverse group of women, comparing those with and without a history of GDM. Even after accounting for factors like age, education, and lifestyle, the results indicated that prior GDM was associated with lower cognitive performance. This connection raises important questions about the long-term effects of pregnancy-related health issues on the brain's aging process.
These findings highlight the importance of monitoring and supporting women's health beyond the childbearing years. Early detection and management of GDM could be crucial not only for immediate pregnancy outcomes but also for safeguarding cognitive health later in life. As our understanding of the interplay between metabolic health and brain function deepens, it becomes increasingly clear that proactive healthcare measures during and after pregnancy are essential for long-term well-being.
Article Information
Lifetime history of gestational diabetes and cognitive function in parous women in midlife
Published in Diabetologia. Soria-Contreras DC et al.
Abstract
Aims/hypothesis: We aimed to determine whether a history of gestational diabetes mellitus (GDM) is associated with cognitive function in midlife.
Methods: We conducted a secondary data analysis of the prospective Nurses' Health Study II. From 1989 to 2001, and then in 2009, participants reported their history of GDM. A subset participated in a cognition sub-study in 2014-2019 (wave 1) or 2018-2022 (wave 2). We included 15,906 parous participants (≥1 birth at ≥18 years) who completed a cognitive assessment and were free of CVD, cancer and diabetes before their first birth. The primary exposure was a history of GDM. Additionally, we studied exposure to GDM and subsequent type 2 diabetes mellitus (neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only or GDM followed by type 2 diabetes) and conducted mediation analysis by type 2 diabetes. The outcomes were composite z scores measuring psychomotor speed/attention, learning/working memory and global cognition obtained with the Cogstate brief battery. Mean differences (β and 95% CI) in cognitive function by GDM were estimated using linear regression.
Results: The 15,906 participants were a mean of 62.0 years (SD 4.9) at cognitive assessment, and 4.7% (n=749) had a history of GDM. In models adjusted for age at cognitive assessment, race and ethnicity, education, wave of enrolment in the cognition sub-study, socioeconomic status and pre-pregnancy characteristics, women with a history of GDM had lower performance in psychomotor speed/attention (β -0.08; 95% CI -0.14, -0.01) and global cognition (β -0.06; 95% CI -0.11, -0.01) than those without a history of GDM. The lower cognitive performance in women with GDM was only partially explained by the development of type 2 diabetes.
Conclusions/interpretation: Women with a history of GDM had poorer cognition than those without GDM. If replicated, our findings support future research on early risk modification strategies for women with a history of GDM as a potential avenue to decrease their risk of cognitive impairment.
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