“The results of the study are highly promising and in line with previous published [type 2 diabetes] prevention studies,” Saila B. Koivusalo, MD, of the department of obstetrics and gynecology at the University of Helsinki and Helsinki University Hospital, told Endocrine Today. “These findings may have major health consequences for both the mother and the child.”
Saila B. Koivusalo
Koivusalo and colleagues analyzed data from 293 pregnant women with a history of gestational diabetes and/or a pre-pregnancy BMI of at least 30 kg/m² (mean age, 32 years; mean pre-pregnancy BMI, 32 kg/m²; baseline gestational age, 13 weeks).
Within the cohort, 144 women (50 with history of gestational diabetes) were randomly assigned to an intervention group, which included lifestyle counseling from study nurses and dietitians who individualized a nutrition plan and a physical activity program for each woman. Participants had free access to public swimming pools and guided exercise groups once a week. The control group (n = 125; 38 with history of gestational diabetes) received general information brochures on diet and physical activity typically provided by antenatal clinics, as well as standard antenatal care. Both groups completed food frequency questionnaires and reported physical activity before each visit to a study nurse.
Among women within the intervention group, 13.9% were diagnosed with gestational diabetes (95% CI, 8.7-20.6) vs. 21.6% in the control group (95% CI, 14.7-29.8). Gestational weight gain also was lower in the intervention group, with women who received counseling losing 0.58 kg more than controls (P = .037). Women in the intervention group also increased their median weekly physical activity by 15 minutes. Physical activity in the control group remained unchanged.
“This is, to our knowledge, the first randomized controlled lifestyle intervention trial that has succeeded in reducing the overall incidence of [gestational diabetes] among high-risk pregnant women,” the researchers wrote. “As a result of the combined moderate physical activity and diet intervention, the overall incidence of [gestational diabetes] was reduced by 39%.”
Researchers noted that all women in the cohort were at high risk for developing the disease; therefore, the effect could be more pronounced in an unselected high-risk population.
Pregnant women at high risk for developing gestational diabetes can reduce their chances of developing the disease by as much as 39% through a series of moderate lifestyle changes, according to research in Diabetes Care.
“[Gestational diabetes] is a well-known risk factor for later type 2 diabetes, and prevention of [gestational diabetes] may have positive consequences for the mother in her later life but also for the offspring through the intrauteric programming process,” Koivusalo said.
“It would be very interesting to focus more on factors within the different subgroups in order to identify the women who benefited most from the intervention,” Koivusalo said. “Focusing upon different ethnic groups is of major importance. The long-term consequences of the given prevention on both the women’s and children’s later health is another important topic.”
Disclosure: The researchers report no relevant financial disclosures.
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