Interventions May Prevent Type 2 Diabetes After Gestational Diabetes

Exercise in Pregnancy Decreases Cesarean Risk, Weight Gain
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Intensive lifestyle changes or metformin may decrease the risk for type 2 diabetes in women with gestational diabetes.

Type 2 diabetes risk remains high in women with a history of gestational diabetes, but intensive lifestyle changes and a medication regimen involving metformin may prevent progression of the disease, according to data published in the Journal of Endocrinology & Metabolism.

“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,” study author Vanita Aroda, MD, of the MedStar Health Research Institute in Hyattsville, Maryland, said in a press release.

Approximately 9.2% of women develop gestational diabetes while pregnant, data from the CDC suggest, and risk for development of diabetes is heightened in these women for years after giving birth.

To determine whether certain interventions may protect women with gestational diabetes from developing type 2 diabetes later in life, researchers from the Diabetes Prevention Program Outcomes Study (DPPOS) evaluated the metabolic health of women with gestational diabetes and those without the condition who participated in the trial.

A total of 288 women with a history of gestational diabetes and 1,226 women without the condition participated in the DPPOS and completed the follow-up study.

In the DPPOS, participants were randomly assigned to intensive lifestyle intervention, metformin or placebo. The intensive lifestyle intervention aimed to decrease body weight by 7% and involved participation in at least 150 minutes of moderate-intensity physical activity per week. In the medication intervention arm, metformin 850 mg was administered twice daily.

During the study, women continued to have their blood glucose levels measured twice a year for 6 years. Long-term health outcomes in the DPP participants were evaluated for about a decade after the women first enrolled in the study.

Over 10 years, risk for developing diabetes was 48% higher in women with a history of gestational diabetes in the placebo group vs. those without a history of the condition. However, the intensive lifestyle intervention and metformin reduced progression to diabetes by 35% and 40%, respectively, when compared with placebo, according to study results.

In women without a history of gestational diabetes, the intensive lifestyle intervention decreased progression to diabetes by 30%. Metformin, however, did not reduce progression to diabetes in this group.

“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,” Dr. Aroda said.


  1. Aroda VR et al. J Clin Endocrinol Metab. 2015;doi:10.1210/jc.2014-3761.