Cutting risk of diabetes during pregnancy

Gestational diabetes is a type of diabetes that develops during pregnancy — most often in the second or third trimester. Although gestational diabetes goes away after the mother has given birth, women who have had gestational diabetes have a 35-60% chance of developing diabetes in the following 10-20 years. The condition can also lead to risks for the baby, such as excess growth, birth defects and could be at a higher risk of becoming obese or intolerant to glucose when growing up. In such cases, an elective or emergency caesarean may be necessary to deliver the baby.

During pregnancy, placenta releases hormones that block how the insulin works and thus raise the blood sugar, the purpose being to provide energy for the baby. Therefore, even in a normal pregnancy the pancreas has to make a lot of extra insulin just to keep the situation controlled. When the pancreas is not making enough insulin to overcome the blockage from these hormones, the blood sugar will rise, and this is called gestational diabetes.

According to a new study published in BMJ, healthy lifestyle habits could prevent about half of this diabetes cases that develop during pregnancy.

Researchers found that the strongest risk factor for diabetes during pregnancy was being overweight or obese during pregnancy. Women who were obese before pregnancy had more than a four times higher risk of gestational diabetes than those who had a normal weight before pregnancy.

Women who were at a normal weight at the start of pregnancy, and who did not smoke and were physically active had a 52 percent lower risk of developing gestational diabetes than other women, according to the researchers.

The strongest association was found for women who had all of the healthy lifestyle behaviors: a normal weight, healthy eating, exercise and no smoking. These women were 83 percent less likely to develop gestational diabetes than those with none of those habits, the researchers reported.

The researchers believe that almost half of all gestational diabetes could be prevented if women were at a normal, healthy weight before pregnancy, did not smoke and participated in regular physical activity.

But, even women who were overweight or obese before pregnancy reduced their risk of gestational diabetes if they exercised, did not smoke and ate a healthy diet.

The researchers from the National Institutes of Health in Maryland acknowledged that it can be difficult to change lifestyle behaviours. However, they suggested that the time before and during pregnancy could represent an opportunity to change diet and lifestyle as these women might be particularly motivated to adhere to advice to improve pregnancy and/or birth outcomes.