New evidence suggests that healthy eating and regular exercise during pregnancy may not be as beneficial as previously thought in gestational diabetes prevention.
Gestational diabetes can lead to negative outcomes for both the mother and child later in their lives. Women with a history of gestational diabetes have a higher risk of developing type 2 diabetes and children born to women with gestational diabetes have a higher risk of being overweight or obese, thus increasing their risk of type 2 diabetes as well.
Early data has suggested that the development of type 2 diabetes and gestational diabetes are similar because of their shared risk factors such as a poor diet high in calories and a lack of physical exercise. As a result, lifestyle modifications to diet and exercise is a first-line recommended strategy for gestational diabetes prevention.
In a study published in Cell Metabolism, researchers from the United States evaluated the role of energy intake and expenditure on gestational weight gain and the risk of developing gestational diabetes. In this observational prospective study, the researchers assessed the energy balance in 62 pregnant women with obesity and compared this between women who developed gestational diabetes during the study and those who did not. Nine women developed gestational diabetes.
The study analysis found that the energy balance in the gestational diabetes group and the normal control group did not differ, as caloric intake and caloric expenditure were comparable between the two groups. Physical activity, weight gain, and fat distribution were also found to be similar between the two groups during the study. The study results conclude that energy balance does not contribute to gestational diabetes development.
The study noted that the women who developed gestational diabetes were heavier and had more fat tissue, particularly deep tissue fat. These women also had higher fasting blood sugar and HbA1c levels, and thus a higher rate of prediabetes. Further, a greater prevalence of first degree relatives with diabetes was reported in the women who developed gestational diabetes. These findings suggest that gestational diabetes is unique to every individual, and lifestyle changes will not have a uniform impact on gestational diabetes prevention.
Although the study recognizes it is limited by their small number of study subjects, they conclude that healthy eating and physical exercise may not be the fundamental strategies in gestational diabetes prevention, despite being the current recommendation. The study does not imply that a healthy lifestyle during pregnancy does not have potential benefits, rather it highlights the need to better understand how and why gestational diabetes develops in pregnant women.
Future studies should aim to identify factors that put pregnant women at a higher risk for gestational diabetes so that evidence-based strategies for gestational diabetes prevention can be developed.
Written by Maggie Leung, PharmD
- Most, J., Broskey, N. T., Altazan, A. D., Beyl, R. A., Amant, M. S., Hsia, D. S., . . . Redman, L. M. (2018). Is Energy Balance in Pregnancy Involved in the Etiology of Gestational Diabetes in Women with Obesity? Cell Metabolism. doi:10.1016/j.cmet.2018.12.002
- Griggs, T. (2019, January 7). Balanced diet, exercise may not prevent gestational diabetes. Retrieved January 8, 2019, from https://www.eurekalert.org/pub_releases/2019-01/lsu-bde122118.php