Women who develop gestational diabetes during pregnancy have a significant risk of getting type 2 diabetes either soon after giving birth or within the next ten or more years.
As many as 18 percent of pregnant women in the United States are diagnosed with gestational diabetes, a condition in which diabetes develops for the first time during pregnancy. Gestational diabetes can lead to various complications, including having a large baby (with associated risks during labor and delivery), and giving birth to an infant with very low blood glucose levels and/or breathing problems.
Despite the high risk of type 2 diabetes among women with a history of gestational diabetes, few studies have examined modifiable risk factors, which could help these women prevent the disease. Therefore a research team examined data from 4,413 women who participated in the Nurses’ Health Study II and who had a history of gestational diabetes.
All the women were followed from 1991 through 2005 using a food frequency questionnaire, which was completed every four years. Three dietary patterns were evaluated using a point system: the alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and alternate Healthy Eating Index (aHEI).
These three dietary approaches have previously been shown to be associated with a reduced risk of type 2 diabetes and cardiovascular disease in the general population. All three diets have similar characteristics regarding intake of fruits and vegetables, low consumption of red and processed meats, carbohydrate quality, and low intake of saturated fats.
When the authors reviewed the follow-up data and the dietary information, they found the following:
- A total of 491 women developed type 2 diabetes during the follow-up period
- Mean time to a diagnosis of type 2 diabetes after gestational diabetes was 13.8 years
- All three dietary approaches were associated with a reduced risk of developing type 2 diabetes
- The Healthy Eating Index (aHEI) diet pattern was associated with a 57% lower risk of type 2 diabetes, DASH with a 46% lower risk, and aMED with a 40% lower risk
Although all three dietary plans have similar characteristics, several factors within each individual diet were more likely to be associated with a lower risk of type 2 diabetes. For example:
- For aMED, these factors included vegetable consumption, moderate alcohol use, and intake of fish and seafood.
- For DASH, the factors were intake of vegetables, reduced consumption of red and processed meats, and less consumption of sugar-sweetened beverages.
- For the aHEI pattern, the factors were vegetable intake, greater intake of white versus dark meat, moderate alcohol consumption, greater intake of fiber from cereals, and long-term use of multivitamins.
The results of this study indicate that women with a history of gestational diabetes may reduce their risk of developing type 2 diabetes in the future if they follow a healthy diet. The authors noted that women should be encouraged to eat a diet rich in whole grains, fruits, and vegetables and to select white meat, seafood, legumes, and nuts for protein while reducing their intake of red and processed meats and avoiding sugar-sweetened beverages.
Coustan DR et al. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. American Journal of Obstetrics & Gynecology 2010; 202(6): 654 e1-6
Tobias DK et al. Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus. Archives of Internal Medicine 2012 Sept 17. Published online. doi:10.1001/archinternmed.2012.3747