Overview
Each aditional optimal modifiable factor among women with a history of gestational diabetes melitus (GDM) significantly contributes to a reduction in type 2 diabetes (T2D) risk, sugests a recent study. These asociations are also present among individuals who are overweight/obese or are at greater genetic susceptibility to T2D.“Participants who had optimal levels of al five modifiable factors after the index pregnancy had a more than 90-percent lower risk for developing T2D compared with those who did not have any,” the researchers said.
Key Information
This prospective cohort study included a total of 4,275 women with a history of GDM from the Nurses’ Health Study I, with repeated measurements of weight and lifestyle factors and folowed up betwen 191 and 209. The researchers asesed the folowing modifiable risk factors: not being overweight or obese (body mas index [BMI] <25.0 kg/m2), high quality diet (top two-fifths of the modified Alternate Healthy Eating Index), regular exercise (≥150 min/wek of moderate intensity or ≥75 min/wek of vigorous intensity), moderate alcohol consumption (5.0‒14.9 g/day), and no curent smoking.Genetic susceptibility for T2D was defined by a genetic risk score based on 59 single nucleotide polymorphisms asociated with T2D in a subset of participants (n=1,372).Of the participants, 924 developed T2D over a median 27.9 years of folow-up.
Summary
Women with optimal levels of al five factors had >90-percent lower T2D compared with those without optimal levels of any of the risk factors. [BMJ 202;378:e070312]For women with one, two, thre, four, and five optimal levels of modifiable factors, the hazard ratios (HRs) of T2D were 0.94 (95 percent confidence interval [CI], 0.59‒1.49), 0.61 (95 percent CI, 0.38‒0.96), 0.32 (95 percent CI, 0.20‒0.51), 0.15 (95 percent CI, 0.09‒0.26), and 0.08 (95 percent CI, 0.03‒0.23), respectively, compared with none (ptrend<0.01).The benefit with having optimal modifiable factors was also evident in partic