Balanced diet, exercise may not prevent gestational diabetes

January 07, 2019

It may be time to reconsider the conventional wisdom for preventing gestational diabetes: limiting weight gain and increasing physical activity.

"Our data suggest that in pregnancy, energy balance - the calories consumed versus the calories burned - may not determine the development of gestational diabetes," said Leanne Redman, PhD, director of LSU Pennington Biomedical Research Center's Reproductive Endocrinology and Women's Health Lab. "We and others now believe that there are different types of gestational diabetes that warrant different approaches to treatment and prevention."

The new Pennington Biomedical study is the latest evidence that the "first-line" strategy for preventing gestational diabetes mellitus isn't working. Over the past five years, more than 5,000 pregnant women took part in clinical trials that focused on limiting weight gain in order to prevent gestational diabetes.

The result? The moms-to-be improved their diet quality, ate less, and increased their physical activity. They also developed gestational diabetes at about the same rates as the women who didn't change their diet or activity levels.

"Preventing gestational diabetes is not as simple as reducing weight gain," said Jasper Most, PhD, co-lead author of the study. "It may require more individualized approaches based on each person's risk factors."

Some women may develop gestational diabetes because their pancreas doesn't adapt adequately to producing additional insulin to match the increased demand of pregnancy, Dr. Most said. Others may develop gestational diabetes because their muscles and livers become more insulin resistant.

Most and Nicholas Broskey, PhD, are co-lead authors of Pennington Biomedical's new study published in Cell Metabolism. Both are postdoctoral researchers in the Reproductive Endocrinology and Women's Health Lab.

The five-year study looked at 62 pregnant women with obesity. Nine developed gestational diabetes.

Researchers found that:

"But the results do underscore the need to better understand the way that gestational diabetes develops in women with obesity," Dr. Redman said.

New research is needed into other factors that lead to insulin resistance in pregnancy, Dr. Redman said. In their next study, the scientists hope to better classify the different types of gestational diabetes and to study energy balance in addition to insulin secretion.

Gestational diabetes leads to health issues for the mother and child, issues which can extend well beyond pregnancy. Among other things, around 50 percent of the women with gestational diabetes go on to develop type 2 diabetes, according to the federal Centers for Disease Control. Babies exposed to gestational diabetes are more likely to develop type 2 diabetes and have a higher risk of being overweight or developing obesity.
-end-
The study was funded by the National Institutes of Health (R01DK099175); and in part by U54GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center; and Nutrition Obesity Research Center Grant P30DK072476, titled "Nutrition and Metabolic Health Through the Lifespan," sponsored by the National Institutes of Diabetes and Digestive and Kidney Diseases.

About the Pennington Biomedical Research Center

The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. It is a campus of Louisiana State University and conducts basic, clinical and population research. The research enterprise at Pennington Biomedical includes approximately 60 faculty and more than 20 postdoctoral fellows within a network of 40 laboratories supported by lab technicians, nurses, dietitians, and support personnel, and 13 highly specialized core service facilities. Pennington Biomedical's more than 450 employees perform research activities in state-of-the-art facilities on the 222-acre campus located in Baton Rouge, Louisiana. For more information, see http://www.pbrc.edu.

Louisiana State University

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.