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 the senior author. "We and others now believe that there are different types of gestational diabetes that warrant different approaches to treatment and prevention."
The new study published in Cell Metabolism 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 the 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. Others may develop gestational diabetes because their muscles and livers become more insulin resistant.
New research is needed into other factors that lead to insulin resistance in pregnancy, the senior author 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.
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30739-3
Gestational diabetes may not be prevented by balanced diet and exercise
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