More Activity: Less Risk of Gestational Diabetes Progressing to Type 2 Diabetes

Physical activity in woman (Credit: hey mr glen/flickr)Main Point:

Increased physical activity among women who had gestational diabetes mellitus (GDM) can lower the risk of progression to Type 2 diabetes mellitus (T2DM).

Published in:

JAMA Internal Medicine

Author:

Wei Bao, M.D., Ph.D., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Md., and colleagues.

Background:

GDM is a common pregnancy complication, defined as glucose intolerance with onset or first recognition during pregnancy. T2DM is an escalating worldwide epidemic and preventing the disease is a global health priority. About one-third of women of reproductive age with T2DM have a history of GDM, so a diagnosis of GDM may provide an opportunity for women to recognize the increased risk of T2DM and take steps to try to prevent it in the future.

How the Study Was Conducted:

The authors examined the role of physical activity, television watching and other sedentary activity, along with changes in these behaviors, in the progression to T2DM. The study included 4,554 women from the Nurses’ Health Study II who had a history of GDM and were followed from 1991 to 2007.

Results:

The authors documented 635 cases of T2DM. Each increase in an increment of 5-metabolic equivalent hours per week (MET-h/wk), which is equal to about 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous-intensity activity, was associated with a 9 percent lower risk of T2DM. Women who increased their total physical activity levels by the federal government recommendation of 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activity or 75 minutes per week of vigorous-intensity activity) had a 47 percent lower risk of T2DM. While an increase in physical activity was associated with a lower risk for T2DM, an increase in the amount of time spent watching TV was associated with a greater risk of T2DM.

Discussion:

“These findings suggest a hopeful message to women with a history of GDM, although they are at exceptionally high risk for T2DM, promoting an active lifestyle may lower the risk.”

Reference:

Wei Bao MD, PhD, Deirdre K. Tobias ScD, Katherine Bowers PhD, Jorge Chavarro MD, ScD, Allan Vaag PhD, DMSc, Louise Groth Grunnet PhD, Marin Strøm PhD, James Mills MD, Aiyi Liu PhD, Michele Kiely DrPH, Cuilin Zhang MD, PhD. Physical Activity and Sedentary Behaviors Associated With Risk of Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus: A Prospective Cohort Study. JAMA Intern Med. 2014; 174(7):-. doi:10.1001/jamainternmed.2014.1795

Editor’s Note:

The study was funded by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, and grants from the National Institutes of Health. An author was also supported by an American Diabetes Association fellowship. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: Call to Increase Physical Activity Among Women of Reproductive Age

In a related commentary, Monique Hedderson, Ph.D., and Assiamira Ferrara, M.D., Ph.D, of Kaiser Permanente Northern California, Oakland, write: “The study by Bao et al in this issue sends a hopeful message to women with GDM, suggesting that it is possible to reduce diabetes risk through modifiable 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.”

Reference:

Monique Hedderson PhD, Assiamira Ferrara MD, PhD. A Call to Increase Physical Activity Among Women of Reproductive Age: Is It Possible? JAMA Intern Med. 2014; 174(7):-. doi:10.1001/jamainternmed.2014.709

Editor’s Note:

Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory:

To contact corresponding author Cuilin Zhang, M.D., Ph.D., call Robert Bock at 301-496-5134 or email bockr@mail.nih.gov. To contact commentary author Monique Hedderson, Ph.D, call Janet L. Byron at 510-891-3115 or email janet.l.byron@kp.org.

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