OBJECTIVE -We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with firstdegree relatives with type 2 diabetes. RESEARCH DESIGN AND METHODS -Women with (n ϭ 332) and without (n ϭ 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported

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... RESULTS -Women with prior GDM were younger (48.6 Ϯ 0.7 vs. 52.4 Ϯ 0.6 years [means Ϯ SE]; P Ͻ 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P Ͻ 0.005). Although both groups were obese (BMI 34.4 Ϯ 1.2 vs. 33.7 Ϯ 0.6 kg/m 2 ), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P Ͻ 0.001) and type 2 diabetes (93.4 vs. 63.3%; P Ͻ 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21-2.82]; P ϭ 0.005) that occurred at a younger age (45.5 Ϯ 2.2 vs. 52.5 Ϯ 1.9 years; P ϭ 0.02) and was independent of metabolic syndrome (1.74 [1.10 -2.76]; P ϭ 0.02) and type 2 diabetes (1.56 [1.002-2.43]; P Ͻ 0.05). CONCLUSIONS -Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes. Diabetes Care