Women with a history of gestational diabetes can dramatically cut their chances of developing type 2 diabetes later on with healthy lifestyle changes, research has found.
Analysis of data from a large US study found that those who had a healthy weight, high-quality diet, regular physical activity, moderate alcohol consumption, and did not smoke had a 92% lower chance of developing diabetes than those who did not meet any of the criteria.
The findings are based on 28 years of follow up of 4,275 women with a history of gestational diabetes who took part in the Nurses Health Study II in the US, where 924 women ended up developing type 2 diabetes.
Each of the additional five modifiable risk factors looked at was associated with an incremental lowering in the chances of diabetes.
Women with one ‘optimal risk factor’ had a 6% reduced risk of diabetes compared with those who had none. For two modifiable risk factors there was a 39% reduced risk, with 68% and 85% for three and four respectively.
Reporting in the BMJ, the researchers said that the inverse association persisted among women who were overweight or obese, or who had a greater genetic risk of type 2 diabetes.
They noted that the study included mainly healthcare professionals of European ancestry, so the results may not apply to other ethnic or socioeconomic groups.
‘This study highlights the important public health opportunity for the prevention of type 2 diabetes in this high-risk population,’ they concluded.
A second study, also published in the BMJ, found that diabetes in pregnancy is linked to an increased risk of cardiovascular and cerebrovascular diseases, underpinning the importance of early intervention and monitoring in this group, the researchers concluded.
Combining data from 15 studies published between 2006 and 2022 showed women with a history of gestational diabetes have a 72% increased risk of cardiovascular diseases and 40% increased risk of cerebrovascular disease.
And the risk of venous thromboembolism was seen to increase by 28% in women with previous gestational diabetes.
Their analysis found the increased risk could not be solely attributed to conventional cardiovascular risk factors or subsequent diabetes.
‘The results highlight the need for early intervention in women at high risk of gestational diabetes mellitus, and for continuous monitoring of women with gestational diabetes mellitus,’ they said.
In 2018, new guidance said GPs should help obese women to lose weight before and between pregnancies, to reduce their risk of developing gestational diabetes and other complications.