The risk of developing type 2 diabetes is very high in women with a past history of gestational diabetes mellitus (GDM). This post-hoc analysis from the Diabetes Prevention Program examined baseline characteristics and response to intervention in women with a history of GDM (n=350) compared to parous (having produced offspring) women (n=1,416) without a history of GDM. The main objective of the Diabetes Prevention Program was to document the effects of standard lifestyle and placebo, or metformin, or an intensive lifestyle modification program on the prevention or delay of diabetes in individuals with impaired glucose tolerance over 3 years. At baseline, the degree of glucose intolerance was similar between the two groups of women. In women randomized to placebo, the incidence of diabetes in those with GDM was 71% higher than in women without a history of GDM. Intensive lifestyle modification reduced the incidence of diabetes by about 50% in both groups of women compared to the placebo group. In women randomized to metformin, reductions in the incidence of diabetes were 50.4% and 14.4% in those with and without GDM, respectively. In women with a history of GDM, the similar reduction in the incidence of diabetes between those on metformin vs. those on intensive lifestyle could be explained by the minimal weight loss achieved in GDM women under intensive lifestyle modification. In conclusion, intensive lifestyle modification or metformin are highly effective in the prevention or delay of diabetes in women with impaired glucose tolerance and a past history of GDM.
Documentation centre