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Interventions decrease long-term diabetes risk in women with gestational diabetes
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The risk for type 2 diabetes is increased among women with a history of gestational diabetes, even years after giving birth, according to study findings published in The Journal of Clinical Endocrinology & Metabolism.
However, a protective effect in the population can be found with intensive lifestyle intervention or a medication regimen, according to the researchers.
“Our long-term follow-up study found the elevated risk of developing type 2 diabetes persisted for years in women who had been diagnosed with gestational diabetes, and this long-term risk can be reduced with either intensive lifestyle intervention or the medication metformin,” Vanita Aroda, MD, of the MedStar Health Research Institute in Hyattsville, Maryland, said in a press release.
Aroda and colleagues evaluated data from 288 women with a previous diagnosis of gestational diabetes and 1,226 mothers without such a history from the Diabetes Prevention Program Outcomes Study to determine the effect on development of type 2 diabetes of intensive lifestyle and metformin interventions during 10 years. At study entry, all participants had elevated BMI and fasting glucose as well as impaired glucose tolerance.
Participants were randomly assigned to an intensive lifestyle intervention that aimed for a 7% weight loss and 150 minutes or more of moderate-intensity physical activity per week, 850 mg metformin twice per day or placebo. Standard, nonintensive lifestyle counseling was also given to participants assigned to metformin or placebo.
Compared with the metformin and intensive lifestyle groups, participants assigned to placebo were more likely to develop diabetes. There was a 48% increased risk for diabetes among participants who had had gestational diabetes and were assigned placebo, compared with those who never had gestational diabetes (P < .05).
Participants with gestational diabetes history had a 35.2% decreased risk for diabetes with intensive lifestyle intervention and a 40.4% decreased risk with metformin.
“Medical and lifestyle interventions were remarkably effective at slowing the progression of type 2 diabetes in this at-risk population in both the short and long term,” Aroda said in the release.
“We conclude that women with elevated BMI, elevated fasting glucose, impaired glucose tolerance, and a history of [gestational diabetes] are at increased short- and long-term risk of developing diabetes, and this risk can be reduced substantially with either lifestyle intervention or metformin,” the researchers wrote. – by Amber Cox
Disclosure: Aroda reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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