Exercise may not prevent diabetes in pregnant women

Gestational diabetes affects 12 to 14 per cent of all pregnant women in Australia. It can lead to adverse health outcomes for both mother and child even after pregnancy. About 50 per cent of the women with gestational diabetes go on to develop type 2 diabetes and infants exposed to gestational diabetes are more likely to develop type 2 diabetes and are at a higher risk of being overweight or developing obesity. Pregnant women are recommended to limit weight gain and to increase physical activity to prevent gestational diabetes. However, a new research has found evidence that these strategies are not working.

Even when women ate less, improved their diet and increased physical activity, they still developed gestational diabetes at the same rate as women who didn’t change their diet or their activity levels.

Past clinical trials involving more than 5000 pregnant women who have focused on limiting weight gain in order to prevent gestational diabetes have shown that even when women ate less, improved their diet and increased physical activity, they still developed gestational diabetes at the same rate as women who didn’t change their diet or their activity levels. It seems that to prevent gestational diabetes women need a more individualised approach and that just losing weight and adjusting their diet is not enough.The new five-year study looked at 62 women with obesity out of which nine women developed gestational diabetes. The researchers found that:

• The primary risk factors for gestational diabetes, such as excess fat and insulin resistance, were evident early in pregnancy.
• Women that developed gestational diabetes tended to be heavier. They weighed 4.5 kilos to nearly 16 kilos more. They also had more body fat with significantly more fat around their waists.
• The women also had more relatives with diabetes.
• They had significantly higher fasting blood sugar levels and a greater prevalence of prediabetes.

The research shows that energy balance — the calories consumed versus the calories burned — may not determine the development of gestational diabetes and that there are different types of gestational diabetes which require different approaches to treatment and prevention. While further studies are needed to further investigate the different types of gestational diabetes and to understand energy balance and insulin secretion, the researchers advise that pregnant women should not stop eating a healthy diet or reduce their physical activity during pregnancy.

Source: Cell Metabolism