Physical Activity and Sedentary Behaviors Associated With Risk of Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus: A Prospective Cohort Study

Study Questions:

What are the roles of physical activity and television watching and other sedentary behaviors in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM)?

Methods:

This was a prospective cohort study of women from the Nurses’ Health Study II. Women were followed up from 1991 to 2007. Physical activity and sedentary behaviors were assessed in 1991, 1997, 2001, and 2005. The main outcome was self-reported incident T2DM.

Results:

There were 635 incident cases of T2DM among 4,554 women with a history of GDM. An increase of physical activity was associated with a lower risk of T2DM with each 5-metabolic equivalent hour/week increment of total physical activity (which is equivalent to 100 minutes per week of moderate-intensity physical activity) associated with a 9% lower risk of T2DM (adjusted relative risk, 0.91; 95% confidence interval, 0.88-0.94). The association persisted after adjustment for body mass index (BMI). Although an increase of time spent watching TV was associated with a greater risk of T2DM, the association was no longer significant after additional adjustment for BMI.

Conclusions:

The authors concluded that in women with GDM, a higher level of physical activity is associated with a lower risk of T2DM, independent of BMI.

Perspective:

Women with GDM are at markedly escalated risk of developing T2DM. This cohort study demonstrates the clear benefits of physical activity in mitigating the risk of progression to T2DM. Recommendations for physical activity and healthy lifestyle should not be overlooked when counseling women with GDM.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Exercise

Keywords: Risk, Diabetes, Gestational, Body Mass Index, Exercise, Counseling, Sedentary Lifestyle, Confidence Intervals, Metabolic Equivalent, Pregnancy


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