Physical Activity May Slow Progression From Gestational To Type 2 Diabetes

Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852MedicalResearch.com Interview with:
Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852

MedicalResearch: What are the main findings of the study?

Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:

(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).

(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.

(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.

MedicalResearch: Were any of the findings unexpected?

Dr. Wei Bao: The findings are expected and biologically plausible. There might be one point to note. We observed that walking and vigorous activity were associated with similarly lower risk of T2DM. Because more women walk than engage in vigorous exercise (especially when they are getting older), these results are reassuring.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Wei Bao:  Increasing physical activity may lower the risk of progression from gestational diabetes mellitus to T2DM. 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.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Wei Bao: In order to translate our findings to practice, it is imperative to develop effective strategy to promote physical activity in women of reproductive age.

Citation:

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

Bao W, Tobias DK, Bowers K, et al.  JAMA Intern Med. Published online May 19, 2014. doi:10.1001/jamainternmed.2014.1795.

 

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