A 10-year study completed by the MedStar Health Research Institute and published in the Journal of Clinical Endocrinology and Metabolism reports that both lifestyle intervention and the drug metformin may be effective at reducing the risk for type 2 gestational diabetes mellitus (GDM)
Development of type 2 diabetes after GDM
This study took a long-term look at the progression to type 2 diabetes in women with a history of gestational diabetes. Women with GDM have the highest risk for developing type 2 diabetes during the first 5 years after pregnancy, but their chances of diabetes developing does not disappear after that time period. The study was part of the Diabetes Prevention Program Outcomes Study that followed up on a previous 3-year Diabetes Prevention Program. The program randomly assigned overweight and obese people at high risk for developing type 2 diabetes to one of three groups. The first group underwent a lifestyle change, losing 7 percent of body weight by doing 150 minutes or more per week of moderate-intensity physical exercise. The second group took 850 mg of metformin twice daily, and the third group was a placebo group. This study’s follow-up found that among the 3,234 participants, either the intensive lifestyle change or taking metformin reduced the risk of or delayed the development of type 2 diabetes for up to 15 years.
Women who had GDM and were given a placebo were at a 48 percent higher risk of developing type 2 diabetes than women who had no history of gestational diabetes, but both lifestyle intervention and metformin were able to reduce progression by up to 40 percent. However, among the women who did not have gestational diabetes, metformin had no impact on their development of type 2 diabetes, while intensive lifestyle intervention still reduced the risk by 30 percent.
The study confirms the importance of metformin for women who had gestational diabetes, as many new mothers are not able to incorporate intensive lifestyle changes into life with a newborn baby.