Gestational diabetes — a form of diabetes that develops during pregnancy, and usually goes away after giving birth — is on the rise, with rates rising dramatically since the beginning of the COVID-19 pandemic. A number of factors are linked to the risk of developing gestational diabetes, including dietary patterns at conception and in early pregnancy, changes to the gut microbiome, and a history of miscarriage. Managing gestational diabetes effectively is important to have a healthy pregnancy, including dietary approaches to keep your blood glucose under control.
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For the latest study, researchers followed 4,275 women with a history of gestational diabetes between 1991 and 2009. During this period, participants repeatedly had their weight measured and answered questions about lifestyle factors including diet, physical activity, alcohol intake, and smoking. A subset of 1,372 participants also had their genetic risk for type 2 diabetes assessed, so that the researchers could look at potential interactions between genetic and lifestyle factors in the risk for type 2 diabetes.
Healthy lifestyle factors linked to reduced type 2 risk
During a median follow-up period of 27.9 years, 924 participants (21.6%) developed type 2 diabetes. Compared with participants who didn’t have optimal levels of any of the five lifestyle factors (body weight, diet, physical activity, alcohol intake, or smoking), those with optimal levels of all five lifestyle factors were 92% less likely to develop gestational diabetes. Participants with optimal levels of four lifestyle factors were 85% less likely to develop type 2 diabetes, while those with optimal levels of three factors were 68% less likely. Having optimal levels of two lifestyle factors meant a 39% lower risk for type 2 diabetes, while an optimal level of just one lifestyle factor reduced this risk by only 6%.
The link between lifestyle factors and risk for type 2 diabetes was seen in participants who were overweight or obese, as well as in those with a higher genetic risk for type 2. For example, among women with overweight or obesity, having optimal levels of the other four lifestyle factors was linked to a 60% lower risk for type 2. Among women with a higher genetic risk for type 2, those with optimal levels of four lifestyle factors were 89% less likely to develop type 2 diabetes — a greater average risk reduction than was seen in the overall group of participants with optimal levels of four lifestyle factors.
The researchers concluded that among women with a history of gestational diabetes, lifestyle factors may play a major role in the risk for type 2 diabetes — especially in those with a higher genetic risk for type 2. These results demonstrate that no single risk factor determines whether someone will develop type 2 diabetes, and underscore the importance of promoting lifestyle behaviors in people with a higher risk for type 2.