Women with gestational diabetes mellitus may undergo cognitive impairments in midlife: Study

A recent analysis of data from the long-running Nurses' Health Study II revealed that women with a history of gestational diabetes mellitus (GDM) may experience cognitive impairments in midlife. The findings published in the Diabetologia journal highlighted a potential link between GDM and decreased cognitive function that calls for further research into early risk modification strategies for the women affected.

This study involved a total of 15,906 women who had given birth at least once and participated in a cognitive sub-study from 2014 to 2022. None of the participants had cardiovascular disease, cancer, or diabetes before their first birth. They underwent cognitive assessments using the Cogstate brief battery that helps to measure psychomotor speed/attention, learning/working memory, and global cognition. The study assessed whether a history of GDM is associated with cognitive function in midlife and if the development of type 2 diabetes after GDM could mediate this relationship.

The women in the study were 62 years old on average, at the time of their cognitive assessments. Of the participants, 4.7% (749 women) reported a history of GDM. After adjusting for several factors like the age at cognitive assessment, race and ethnicity, education level, socioeconomic status, and pre-pregnancy characteristics, the study found that women with a history of GDM scored lower on cognitive function tests when compared to the individuals without GDM. The women with GDM had lower scores in psychomotor speed and attention (β −0.08; 95% CI −0.14, −0.01), as well as global cognition (β −0.06; 95% CI −0.11, −0.01). While the development of type 2 diabetes following GDM accounted for some of the cognitive decline, it explained the association between GDM and poorer cognitive performance just partially.

The study categorized participants into 4 groups based on their GDM and type 2 diabetes status as neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only, and GDM followed by type 2 diabetes. Through a mediation analysis, this research determined that GDM alone contributed to cognitive decline, though the presence of subsequent type 2 diabetes worsened these outcomes. However, even women who did not develop type 2 diabetes after GDM expressed lower cognitive performance. In future studies, these results could encourage physicians to monitor women with a history of GDM more closely for signs of cognitive decline and promote lifestyle interventions to reduce the risk of type 2 diabetes and cognitive disorders.

Reference:

Soria-Contreras, D. C., Wang, S., Liu, J., Lawn, R. B., Mitsunami, M., Purdue-Smithe, A. C., Zhang, C., Oken, E., & Chavarro, J. E. (2024). Lifetime history of gestational diabetes and cognitive function in parous women in midlife. In Diabetologia. Springer Science and Business Media LLC. https://doi.org/10.1007/s00125-024-06270-w