Risk of Type 2 Diabetes after GDM Can Be Reduced

Women with gestational diabetes mellitus could benefit from medical and lifestyle interventions aimed at reducing the chances of later development of type 2 diabetes mellitus, researchers found.

Women with a history of gestational diabetes are at increased risk for type 2 diabetes. However, that risk can be lowered with proper use of preventative medicine and intensive lifestyle intervention, the authors of a long-term study concluded.

Key Points:

- Both an intensive lifestyle intervention and the drug metformin effectively slowed the progression to type 2 diabetes in women with a history of gestational diabetes.

- It was estimated that 7 women with a history of gestational diabetes mellitus would need to be treated to prevent 1 case of diabetes over 10 years.

The Diabetes Prevention Program Outcomes Study analyzed the long-term metabolic health in 288 women who had a previous diagnosis of gestational diabetes and 1226 mothers who did not have a history of the condition. The randomized trial assigned the women to intensive lifestyle intervention, the diabetes medication metformin, or a placebo. The lifestyle intervention sought to guide the women to reduce their body weight by 7% and participate in moderate cardiovascular exercise for 150 minutes a week. Blood glucose levels were measured twice a year for 6 years.

During a 10-year span, women with a history of gestational diabetes who were assigned to placebo had a 48% higher risk of diabetes developing compared with women who did not have a history of gestational diabetes.

Among women who had had gestational diabetes and underwent intensive lifestyle intervention, the risk of developing type 2 diabetes was reduced by 35%. In women with a history of gestational diabetes who were assigned to take metformin, the risk was reduced by 40%.

"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," said author Vanita Aroda, MD, of the MedStar Health Research Institute in Hyattsville, MD.

The authors estimated that 7 women with a history of gestational diabetes would have to be treated with metformin and lifestyle to prevent 1 case of diabetes over 10 years.

The study was published online in the Journal of Clinical Endocrinology & Metabolism.