Cardiovascular health & diabetes in women

Cardiovascular health & diabetes in women

Research areas

  • Women's cardiometabolic health including diabetes - Dr Aya Mousa, Prof Helena Teede
  • CVD risk in reproductive-aged women - A/Prof Lisa Moran

Women's Cardiometabolic Health including Diabetes

Leads, Dr Aya Mousa and Professor Helena Teede

Identifying key biomarkers, mechanisms and interventions to enhance risk prediction, prevention and treatment of women’s cardiometabolic disorders and reducing the burden of diabetes and gestational diabetes and its related health complications.

The research aims to translate key findings from cardiometabolic health work to policy and practice to enable women and their health care providers to make informed, evidence-based decisions regarding their health and that of their offspring. Also, examining diverse approaches to treatment and management of diabetes, ranging from pharmacological therapies to nutrition and lifestyle interventions to biomarkers and risk prediction models.

Women’s Cardiometabolic Health

Maternal disorders are the leading cause of death among children under five, and premature births alone cost the Australian economy >$1.4 billion annually. As maternal age increases, coupled with an increasing prevalence of obesity and associated metabolic disorders, this situation will escalate, with women having to make difficult decisions affecting both their own health and that of their unborn child. Currently, very little is known regarding the safety and efficacy of various interventions in metabolic and reproductive disorders, particularly when these disorders occur in, or co-exist with, pregnancy. This scarcity of information makes it difficult for patients and health professionals to weigh potential risks against benefits, particularly for women who require medications or supplements during pregnancy due to diverse risk profiles and/or comorbidities.

Through multidisciplinary collaboration, internal and external partnerships and innovative approaches to research and translation, we aim to address this evidence gap to improve our understanding of women’s cardiometabolic health during the reproductive lifespan and to facilitate informed decision-making for health professionals, patients, and communities.

Implementation & Impact

We are developing an evidence base of important biomarkers and mechanisms involved in women’s cardiometabolic disorders, and new knowledge regarding the efficacy and mechanisms of action of existing interventions on women’s cardiometabolic health and maternal and fetal outcomes. The overall research program falls into two broad categories: (1) identifying novel biomarkers and mechanisms of cardiometabolic and reproductive disorders, and (2) examining nutritional and pharmacological interventions for improving women’s cardiometabolic and reproductive health. Through collaborations with international clinical leaders in the field, we aim to translate our research findings to relevant stakeholders including clinicians, policy-makers, researchers, health professionals and communities for maximum health impact.

Gestational diabetes

Within this stream, our work extends to examining the impact of hypoglycaemic medications in metabolically high-risk pregnancies, developing risk prediction tools for clinical use in the prediction of adverse pregnancy outcomes and future diabetes risk in women with GDM, and developing and implementing lifestyle interventions for the prevention of diabetes in high-risk women.

Gestational diabetes mellitus (GDM) is a common metabolic disorder of pregnancy, with an increasing incidence in line with obesity and advanced maternal age. Elevated maternal glucose concentrations and GDM increase the risk for adverse pregnancy outcomes including pre-eclampsia, macrosomia and fetal abnormalities, and GDM itself is the strongest population predictor of type 2 diabetes. Mounting evidence suggests that fetal exposure to a hyperglycaemic environment in utero increases susceptibility for future obesity and diabetes in adulthood, further propagating the global burden of diabetes and GDM. Therefore, effective strategies for the prevention and/or treatment of these disorders and their associated complications are of paramount importance. Through multidisciplinary collaborations, partnerships and innovative research methods, we aim to improve our understanding of the pathophysiology of GDM and diabetes, develop and implement effective interventions for prevention, management and treatment, and enhance our understanding of the facilitators and barriers to treatment success.

Implementation & Impact

Utilising clinical trials, meta-analyses, risk prediction tools and epidemiological modelling, we are generating new knowledge regarding the efficacy of interventions for the prevention, management and treatment of GDM and diabetes in pregnant women and postpartum women at high metabolic risk, while uncovering the key mechanisms and biomarkers involved. We aim to translate and implement our research to enhance evidence-based decision-making and address existing health service gaps in clinical practice.

CVD risk in reproductive-aged women

Lead, Associate Professor Lisa Moran

Working to optimise screening and adherence to lifestyle management programs for women at high risk of later heart disease.

We are working on ways to identify the women at high risk of pregnancy complications that could contribute to a higher risk of heart disease after pregnancy, which will to allow us to work with these women earlier in pregnancy to optimise their lifestyle.

We work to adapt existing programs for optimising diet and physical activity, and preventing weight gain during and following pregnancy so that they reflect the needs of women.

During pregnancy, women can develop certain conditions, which can indicate that they have a higher risk of heart disease later in life. These include gestational diabetes, gestational hypertension or pre-eclampsia, spontaneous pre-term birth, intrauterine growth restriction of their fetus or gaining too much weight during pregnancy. Combined, these conditions can affect a third to up to a half of all pregnant women.

The recommended treatment for all of these conditions is lifestyle management including aiming for optimal diet and physical activity. The earlier women receive this treatment then the lower the risk of these conditions will be and the lower their risk of both a complicated pregnancy and heart disease following pregnancy.

We engage women, multidisciplinary researchers and health professionals and stakeholders from health services, community and government in a multi-step program of research to co-design approaches and tools for the screening, recall and lifestyle management, and in the implementation and evaluation activities.

Implementation & Impact

We work to find practical solutions for targeted screening, prevention and treatment opportunities, which can be incorporated into the existing healthcare system, to reduce the risk of heart disease in women. To maximise real world community impact, we will work in partnership with Diabetes Australia to modify the existing GDM Registry and postpartum lifestyle programs.