Clinical implications of a history of pre‐eclampsia in women with type two diabetes mellitus

Pearson, MC; Wang, H; Murdoch, CE; Doney, ASF

doi:10.1111/dme.70046

Diabetes complications

Clinical implications of a history of pre‐eclampsia in women with type two diabetes mellitus

Diabet MedPublished 16 Apr 2025Nested case-control study

Main finding · Microvascular disease after T2D diagnosisResultHazard ratio 1.26 95% CI 1.12–1.42

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Authors' conclusion

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.

Study context

Population: Women with T2D and prior pregnancies (1921–2022), Scottish Care Information for Diabetes data, NHS Tayside and Fife, linked with Scottish maternity morbidity records
Participants: 6,055 women

Comparison: Prior pre-eclampsia (PE) vs PE-free pregnancies
PEn = 726
PE-freen = 5,329reference
Outcome: Microvascular disease after T2D diagnosis

Methodological detailsrecord linkage, Cox regression, linear regression

Record linkage
Cox regression
Linear regression

Main finding

As reported in the abstract

Hazard ratio

1.26

95% CI 1.12–1.42

P < 0.001

PEvs PE-free

HR 1.26 (95% CI 1.12–1.42); P < 0.001

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk with PE ←→ Higher risk with PE →	HR (95% CI)	P value
Diabetic retinopathy	0.20.5125	1.22 (1.07–1.38)	P = 0.003
CKD	0.20.5125	1.35 (1.06–1.71)	P = 0.016
Diabetic proteinuric kidney disease	0.20.5125	2.45 (1.03–5.81)	P < 0.001
	0.20.5125Hazard ratio (log scale)

BMI at T2D diagnosis

P < 0.001

PE38.3 kg/m²

PE-free35.7 kg/m²

Systolic BP at T2D diagnosis

P < 0.001

PE139 mmHg

PE-free135 mmHg

HDL cholesterol at T2D diagnosis

P = 0.002

PE1.18 mmol/L

PE-free1.21 mmol/L

Age at CVD

P < 0.001

PE55.7 years

PE-free60.6 years

Age at all-cause death

P < 0.0001

PE60.1 years

PE-free65.6 years

Outcome	Difference (years)	P value
Age at T2D diagnosisEarlier with PE	3.2	P < 0.001

Original publication

Clinical implications of a history of pre‐eclampsia in women with type two diabetes mellitus. Diabet Med. Published 16 April 2025. doi:10.1111/dme.70046

Read the original article ↗

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