Researchers studied over 6,700 women to understand how gestational diabetes—a type of diabetes that develops during pregnancy—affects heart health years after giving birth. They found that women who had gestational diabetes had lower scores on a heart health checklist called Life’s Essential 8, which measures things like diet, exercise, sleep, blood pressure, and cholesterol. The effect was strongest in the first 20 years after pregnancy, especially for women who developed gestational diabetes after age 35. This research suggests that women with a history of gestational diabetes need extra attention to their heart health after pregnancy.

The Quick Take

  • What they studied: Does having gestational diabetes during pregnancy affect how healthy a woman’s heart is in the years and decades after giving birth?
  • Who participated: 6,721 women aged 20 and older who participated in a national health survey between 2007 and 2018. About 650 of them (roughly 1 in 10) had experienced gestational diabetes during a pregnancy.
  • Key finding: Women with a history of gestational diabetes had noticeably lower heart health scores compared to women who never had gestational diabetes. The difference was biggest in the first 20 years after pregnancy, and women who developed gestational diabetes after age 35 had even bigger problems with their heart health.
  • What it means for you: If you had gestational diabetes during pregnancy, you should pay special attention to your heart health—especially in the first 20 years after giving birth. This means monitoring your blood pressure, cholesterol, weight, diet, exercise, and sleep. Talk to your doctor about regular check-ups and lifestyle changes that can protect your heart.

The Research Details

Researchers looked at health information from a large national survey that collected data from 2007 to 2018. They identified women who had gestational diabetes during pregnancy and compared their current heart health to women who never had it. To measure heart health, they used something called Life’s Essential 8, which is like a report card that scores eight different aspects of health: four lifestyle habits (what you eat, how much you exercise, whether you smoke, and how much you sleep) and four medical measurements (cholesterol levels, blood sugar levels, blood pressure, and body weight). The researchers used statistical methods to account for other factors that might affect heart health, like age, race, and income.

This study design is important because it looks at real-world health data from thousands of people rather than just a small group in a lab. By using Life’s Essential 8 as a measurement tool, the researchers could get a complete picture of heart health—not just one or two measurements. This helps doctors understand the full impact of gestational diabetes on long-term health.

This study is based on a large, nationally representative sample of American women, which makes the findings more reliable and applicable to the general population. The researchers carefully adjusted their analysis to account for other factors that could influence results. However, because this is a cross-sectional study (a snapshot in time rather than following people over many years), it shows associations but cannot prove that gestational diabetes directly causes heart problems. The study relies on women’s memories of whether they had gestational diabetes, which could introduce some errors.

What the Results Show

Women with gestational diabetes history had an overall heart health score that was about 3.88 points lower on a 100-point scale compared to women without this history. When looking just at the medical measurements (blood pressure, cholesterol, blood sugar, and weight), the difference was even bigger—about 7.88 points lower. This means that women with gestational diabetes had worse numbers in these medical categories. The timing of when gestational diabetes developed mattered: women who developed it after age 35 had even lower heart health scores (about 5.87 points lower) compared to women who developed it before age 35 (about 3.37 points lower). When researchers looked at how long ago the pregnancy was, they found that the biggest differences in heart health appeared in women who were within 10-20 years after their pregnancy with gestational diabetes. After 20 years, the differences became smaller, suggesting that the long-term impact of gestational diabetes on heart health decreases over time.

The study found that the lifestyle factors (diet, exercise, smoking, sleep) showed smaller differences between the two groups compared to the medical measurements. This suggests that gestational diabetes primarily affects the body’s ability to regulate blood sugar, blood pressure, and cholesterol—the things your doctor measures with blood tests and checkups—rather than just affecting lifestyle choices. The fact that the effect was strongest in the first 20 years after pregnancy suggests there’s a critical window when women need the most careful monitoring and intervention.

Previous research has shown that gestational diabetes increases the risk of developing type 2 diabetes and heart disease later in life. This new study builds on that knowledge by showing exactly how gestational diabetes affects multiple aspects of heart health at the same time, and by showing that the timing of when gestational diabetes develops (earlier versus later in reproductive years) matters for long-term outcomes. The finding that effects diminish after 20 years is somewhat reassuring and suggests that with proper management, women can reduce their heart disease risk over time.

This study has several important limitations. First, it’s based on a single point-in-time snapshot of health data, not following women over many years, so we can’t be completely certain that gestational diabetes causes the heart health problems or if other factors are involved. Second, the study relies on women remembering whether they had gestational diabetes, and some may not remember accurately or may not have been formally diagnosed. Third, the study doesn’t account for whether women received treatment or made lifestyle changes after their gestational diabetes diagnosis, which could affect the results. Finally, the study primarily includes data from the U.S. population, so results may not apply equally to other countries or populations.

The Bottom Line

Women with a history of gestational diabetes should: (1) Have regular check-ups with their doctor to monitor blood pressure, cholesterol, and blood sugar levels—especially in the first 20 years after pregnancy (high confidence); (2) Maintain a healthy diet, exercise regularly, avoid smoking, and get adequate sleep (high confidence); (3) Maintain a healthy weight (high confidence); (4) Consider more frequent health screenings than women without gestational diabetes history (moderate confidence). These recommendations are especially important for women who developed gestational diabetes after age 35.

This research is most relevant for women who had gestational diabetes during pregnancy, particularly those within the first 20 years after pregnancy and those who developed gestational diabetes after age 35. It’s also important for their healthcare providers, who should monitor these women more closely. Women who never had gestational diabetes can use this as motivation to prevent it during future pregnancies through healthy lifestyle choices. Partners and family members should be aware so they can support women in making heart-healthy choices.

The good news is that this isn’t an immediate emergency. The study shows that the biggest impact on heart health occurs in the first 20 years after pregnancy, so there’s time to make changes. However, the sooner women start paying attention to their heart health after gestational diabetes, the better. Benefits from lifestyle changes like improved diet and exercise can appear within weeks to months for some measures (like blood pressure), while weight loss and cholesterol improvements may take several months. The key is consistency over years and decades.

Want to Apply This Research?

  • Track the four medical measurements from Life’s Essential 8: blood pressure (systolic and diastolic), total cholesterol, fasting blood glucose, and BMI. Set a goal to check these measurements every 3-6 months with your doctor and log the results in the app to see trends over time.
  • Use the app to track the four lifestyle behaviors: daily diet quality (using a simple 1-10 rating), minutes of physical activity per day (goal: 150 minutes per week), smoking status (track days smoke-free), and hours of sleep per night (goal: 7-9 hours). Create daily reminders for exercise and sleep goals, and use the app’s meal logging feature to monitor diet quality.
  • Set up monthly reviews where you look at your trends across all eight metrics. Create alerts for when medical measurements (from doctor visits) fall outside healthy ranges. Use the app to identify which of the four lifestyle areas needs the most improvement and focus on one change at a time. Share your progress with your healthcare provider during regular check-ups to adjust your plan as needed.

This research shows an association between gestational diabetes history and lower heart health scores, but it does not prove that gestational diabetes directly causes heart disease. If you have a history of gestational diabetes, consult with your healthcare provider about your individual risk factors and appropriate screening and prevention strategies. This information is not a substitute for professional medical advice, diagnosis, or treatment. Always speak with your doctor before making significant changes to your diet, exercise routine, or medical care. Women with gestational diabetes should work with their healthcare team to develop a personalized plan for monitoring and maintaining their heart health.