Gestational diabetes (GDM) is an increasingly common pregnancy complication. Women with GDM are at extremely high risk of developing diabetes, especially in the first 5 years after delivery. In their article on the Nurses’ Health Study (NHS) II in this issue of JAMA Internal Medicine, Bao et al1 found that following a GDM pregnancy, increasing physical activity levels were associated with a reduced risk of progression from GDM to diabetes. This finding highlights the importance of developing effective behavioral interventions to increase physical activity after a GDM pregnancy. A randomized clinical trial of one such behavioral intervention, the Diabetes Prevention Program (DPP),2 found that among overweight or obese women with impaired glucose tolerance, an intensive lifestyle intervention, which aimed to achieve weight reduction through both physical activity and a low-fat diet, reduced the risk of developing diabetes by 58%.3 However, the subgroup of women with a history of GDM—approximately 8 years younger than women without a history of GDM—was less likely to adhere to the lifestyle intervention, less successful at sustaining increases in physically activity, and lost less weight than women without a history of GDM.3 These subgroup findings likely signal the challenges faced by women with young families who are struggling to engage in self-care behaviors, such as increasing their physical activity levels, amidst the competing demands of work and family.
Hedderson M, Ferrara A. A Call to Increase Physical Activity Among Women of Reproductive AgeIs It Possible?. JAMA Intern Med. 2014;174(7):1056-1057. doi:10.1001/jamainternmed.2014.709