Exercise may stop progression of gestational diabetes to type 2

Women with gestational diabetes could lower their risk for progression to type 2 diabetes by boosting their physical activity, according to research published in JAMA Internal Medicine.

“This study shows a clear dose-effect association between physical activity and type 2 diabetes risk among women who had gestational diabetes,” Wei Bao, MD, PhD, a visiting postdoctoral fellow at the National Institute of Child Health and Human Development, told Endocrine Today. “The more physical activity the women engaged in after giving birth, the less likely they were to develop type 2 diabetes.”

Wei Bao, MD, PhD

Wei Bao

In a prospective cohort study of 4,554 women with a history of gestational diabetes who had participated in the Nurses’ Health Study II, Bao and colleagues examined how changes in physical activity, television watching and other sedentary activity affected progression of diabetes. Assessments were done at four follow-up points between 1991 and 2007.

The researchers documented 635 cases of type 2 diabetes. For every 5 metabolic equivalent hours per week increment of total physical activity, equal to 100 minutes of moderate physical activity weekly, the risk for type 2 diabetes dropped 9% (RR=0.91; 95% CI, 0.88-0.94). The association remained significant after adjusting for BMI.

Women who upped their total physical activity levels by at least 7.5 metabolic equivalent hours per week, equivalent to 150 minutes of moderate physical activity weekly, decreased their risk for type 2 diabetes by 47% (RR=0.53; 95% CI, 0.38-0.75) vs. women who did not alter their activity levels. This correlation also continued to be significant after BMI adjustment.

The multivariable adjusted RRs for type 2 diabetes associated with weekly television watching were 1 (reference) for 0 to 5 hours, 1.28 (95% CI, 1.04-1.59) for 6 to 10 hours, 1.41 (95% CI, 1.11-1.79) for 11 to 20 hours and 1.77 (95% CI, 1.28-2.45) for 20 or more hours. The association decreased with adjustment for BMI.

In a related commentary, Monique Hedderson, PhD, and Assiamira Ferrara, MD, PhD, both of Kaiser Permanente Northern California, Oakland, wrote that this study “sends a hopeful message” to women with gestational diabetes that it is possible to decrease diabetes risk with modifications in lifestyle behavior.

“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.” – by Allegra Tiver

For more information:

Bao W. JAMA Intern Med. 2014;doi:10.1001/jamainternmed.2014.1795.

Hedderson M. JAMA Intern Med. 2014;doi:10.1001/jamainternmed.2014.709.

Disclosure: The study was funded by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH and research grants from the NIH. One of the researchers was supported by a mentored fellowship from the American Diabetes Association.