Cutting Risk of Gestational Diabetes

Gestational diabetes reduced through diet and exercise

(RxWiki News) Gestational diabetes can affect the health of mothers and their babies. Healthy lifestyle choices by pregnant mothers might reduce the risk of this condition.

Researchers looked at past studies to see if they showed that healthy choices, including diet and exercise, would decrease the chance of gestational diabetes.

The researchers concluded that studies have linked diet, weight loss, and exercise to a decrease in gestational diabetes, but no clear prevention strategy has been identified.

"Ask your OBGYN how diet and exercise can affect pregnancy."

Ilana Halperin, MD, MSc, FRCPC, from the Division of Endocrinology of the Sunnybrook Health Sciences Center at the University of Toronto, was the lead author of this paper reviewing the role of lifestyles on preventing gestational diabetes.

Dr. Halperin and co-author Denice S. Feig, MD, MSc, of the University of Toronto, looked at 13 studies that had previously been done on gestational diabetes.

These studies were clinical trials testing the effects of different factors on gestational diabetes. The research included such options as diet, exercise, nutritional counseling, gym memberships, home-based exercise, individual nutrition plans, high-fiber diets, probiotics, and supervised exercise sessions. Women at weeks 10 to less than 26 weeks were enrolled in the different trials.

When the 13 published studies were reviewed, the researchers found an overall decrease in weight gain during pregnancy of about 10 pounds when the effects from all strategies were averaged.

But in six studies that looked at the effects of different strategies on gestational diabetes, no decrease in gestational diabetes was seen.

In one study of 132 women who attended clinics where some received nutritional counseling and optional psychological counseling, there was a 50 percent decrease in weight gain and fewer women got gestational diabetes. Gestational diabetes occured in 6 percent of the women who received counseling, compared to 29 percent who were not counseled.

In one of the 13 studies reviewed, 256 women either got probiotics in their diet along with dietary counseling or dietary counseling on the amount and type of fat and fiber they ate or no intervention. The probiotic group had a 13 percent occurrence of gestational diabetes; the fat and fiber counseling group had a gestational diabetes rate of 36 percent; and 34 percent of the women in the no intervention group developed gestational diabetes.

Overall, of these 13 studies, only two showed that the examined lifestyle factors had an effect on gestational diabetes risk.

The research team also looked at studies that made comparisons of factors like body mass (BMI), exercise and weight loss on gestational diabetes.

Dr. Halperin and Dr. Feig reviewed a study that found that for each 5 point increase in BMI, the risk of getting gestational diabetes was raised 48 percent. In that study, if women were overweight or obese in their first pregnancy and got pregnant again, the risk of gestational diabetes was cut by 74 percent if they lost six pounds. Pre-pregnancy exercise was associated with a 55 percent lower risk of gestational diabetes and physical activity in early pregnancy reduced risk 25 percent.

After reviewing the published studies, the authors of this paper concluded that weight loss and exercise decreased gestational diabetes in pregnant women, but none of the studies showed how to prevent gestational diabetes. Although, one study found an association between pre-pregnancy exercise and a lower risk of gestational diabetes.

The researchers felt that the reason they did not find a specific lifestyle or diet and exercise program that would prevent gestational diabetes was because the studies did not have enough participants or had too many other factors that complicated the studies, such as different body mass of the women at the start of the studies. Some studies measured gestational diabetes as an observation in studies that were primarily designed to look at other outcomes, like weight loss. Such studies were not designed to test ways to prevent gestational diabetes.

The researchers reported no conflicts of interest.

The authors' report was published in the January issue of Current Diabetes Reports.

Review Date: 
December 19, 2013