CONCLUSIONS Lack of method ologically robust trials gives limited evidence for the success of lifestyle interventions in women with prior GDM .
PURPOSE To systematic ally review lifestyle interventions for women with prior Gestational Diabetes Mellitus ( GDM ) to report study characteristics , intervention design and study quality and explore changes in 1 ) diet , physical activity and sedentary behaviour ; 2 ) anthropometric outcomes and ; 3 ) glycaemic control and diabetes risk .
Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study.
IMPORTANCE Women with a history of gestational diabetes mellitus ( GDM ) are at substantially increased risk of type 2 diabetes mellitus ( T2DM ) . The identification of important modifiable factors could help prevent T2DM in this high-risk population . OBJECTIVE To examine the role of physical activity and television watching and other sedentary behaviors  , and changes in these behaviors in the progression from GDM to T2DM . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 4554 women from the Nurses ' Health Study II who had a history of GDM , as part of the ongoing Diabetes & Women 's Health Study . These women were followed up from 1991 to 2007 . EXPOSURES Physical activity and television watching and other sedentary behaviors  were assessed in 1991 , 1997 , 2001 , and 2005 . MAIN OUTCOMES AND MEASURE Incident T2DM identified through self-report and confirmed by supplemental question naires . RESULTS We documented 635 incident T2DM cases during 59,287 person-years of follow-up . Each 5-metabolic equivalent hours per week ( MET-h/wk ) increment of total physical activity , which is equivalent to 100 minutes per week of moderate-intensity physical activity , was related to a 9 % lower risk of T2DM ( adjusted relative risk [ RR ] , 0.91 ; 95 % CI , 0.88 - 0.94 ) ; this inverse association remained significant after additional adjustment for body mass index ( BMI ) . Moreover , an increase in physical activity was associated with a lower risk of developing T2DM . Compared with women who maintained their total physical activity levels , women who increased their total physical activity levels by 7.5 MET-h/wk or more ( equivalent to 150 minutes per week of moderate-intensity physical activity ) had a 47 % lower risk of T2DM ( RR , 0.53 ; 95 % CI , 0.38 - 0.75 ) ; the association remained significant after additional adjustment for BMI . The multivariable adjusted RRs ( 95 % CIs ) for T2DM associated with television watching of 0 to 5 , 6 to 10 , 11 to 20 , and 20 or more hours per week were 1 ( reference ) , 1.28 ( 1.04 - 1.59 ) , 1.41 ( 1.11 - 1.79 ) , and 1.77 ( 1.28 - 2.45 ) , respectively ( P value for trend < .001 ) ; additional adjustment for BMI attenuated the association . CONCLUSIONS AND RELEVANCE Increasing physical activity may lower the risk of progression from GDM to T2DM . These findings suggest a hopeful message to women with a history of GDM , although they are at exceptionally high risk for T2DM , promoting an active lifestyle may lower the risk
CONCLUSIONS Lack of method ologically robust trials gives limited evidence for the success of lifestyle interventions in women with prior GDM .
PURPOSE To systematic ally review lifestyle interventions for women with prior Gestational Diabetes Mellitus ( GDM ) to report study characteristics , intervention design and study quality and explore changes in 1 ) diet , physical activity and sedentary behaviour ; 2 ) anthropometric outcomes and ; 3 ) glycaemic control and diabetes risk .