Women who have had gestational diabetes can reduce their risk of going on to develop type 2 diabetes by becoming more physically active, epidemiological research has shown. Commentators on the study*, published in JAMA Internal Medicine, say women of reproductive age should be encouraged to increase their level of physical activity.
Researchers led from the National Institutes of Health in the US examined data on 4554 participants in the Nurses’ Health Study II with a history of gestational diabetes (GDM). During follow up from 1991-2007, 635 of these women had a diagnosis recorded of type 2 diabetes.
The risk of progression to type 2 diabetes was about 9% lower for every increase in activity of 5-metabolic equivalent hours per week (MET-h/wk); this is equivalent to about 100 minutes a week of moderate-intensity physical activity or 50 minutes a week of vigorous-intensity activity. Women who increased their total physical activity levels by the US government recommendation of at least 7.5MET-h/wk (150 minutes a week moderate activity or 75 minutes a week vigorous activity) almost halved their risk (47% reduction) of developing type 2 diabetes. Conversely, the more time that women spent watching television, the greater their risk of progression to type 2 diabetes.
The researchers said; “These findings suggest a hopeful message to women with a history of GDM, although they are at exceptionally high risk for T2DM, promoting an active lifestyle may lower the risk.”
Authors of an invited commentary** on the study said it “sends a hopeful message to women with GDM, suggesting that it is possible to reduce diabetes risk through modifiable lifestyle behaviour”. They added: “Considering the urgency of addressing the current diabetes and obesity epidemics, their article is also a call to action for researchers and health systems to develop successful interventions to increase physical activity among women of reproductive age.”
* Bao W, Tobias D K, Bowers K, at al. Physical Activity and Sedentary Behaviors Associated With Risk of Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus: A Prospective Cohort Study. JAMA Intern Med. Published online May 19, 2014. doi:10.1001/jamainternmed.2014.1795
** Hedderson M and Ferrara A. A Call to Increase Physical Activity Among Women of Reproductive Age: Is It Possible? JAMA Intern Med. Published online May 19, 2014. doi:10.1001/jamainternmed.2014.709.