Sedentary behavior, gestational diabetes mellitus, and type 2 diabetes risk: where do we stand?
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REVIEW
Sedentary behavior, gestational diabetes mellitus, and type 2 diabetes risk: where do we stand? Steven T. Johnson1 • Brigid Lynch2 • Jeff Vallance1 • Margie H. Davenport3 Paul A. Gardiner4,5 • Sonia Butalia6
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Received: 21 July 2015 / Accepted: 8 December 2015 Ó Springer Science+Business Media New York 2016
Abstract A substantial number of pregnancies are complicated by gestational diabetes mellitus (GDM) and up to 70 % of women with GDM go on to develop type 2 diabetes. Given the extensive body of research suggesting physical activity reduces the risk of type 2 diabetes, facilitating physical activity, and reducing sedentary time may be effective approaches to promote the health of women with a previous GDM diagnosis. Here, we discuss physical activity, exercise, and sedentary behavior, in the context of GDM and the potential for type 2 diabetes risk reduction. Keywords Gestational diabetes Sedentary Risk Physical activity
& Steven T. Johnson [email protected] 1
Centre for Nursing and Health Studies, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB T9S 3A3, Canada
2
Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia
3
Faculty of Physical Education and Recreation, Alberta Diabetes Institute, Women and Children’s Health Research Institute, University of Alberta, Edmonton, AB, Canada
4
School of Public Health, The University of Queensland, Herston, QLD, Australia
5
Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
6
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
Introduction Gestational Diabetes Mellitus (GDM) occurs in 5–14 % of all pregnancies making it one of the most common complications of pregnancy [1]. GDM is defined as hyperglycemia with first onset or recognition during pregnancy [2]. GDM occurs because the endogenous insulin supply is unable to meet the physiologic requirements against the acute insulin resistance [3]. Currently, it is thought that insulin resistance occurs from increasing placental hormones such as human placental lactogen, placental growth hormone, and tumor necrosis factor alpha and increasing maternal adiposity [3]. A GDM pregnancy is a substantial risk factor for developing type 2 diabetes (T2D) [2, 4]. Although rates of developing T2D in the literature vary due to different patient populations and follow-up periods, up to 70 % of women with GDM develop T2D [4, 5]. In a systematic review and meta-analysis, Bellamy and colleagues found that women with GDM were nearly 10 times more likely to develop T2D compared to women without GDM [6]. The first five years following a GDM pregnancy has been suggested to be the period of greatest risk of developing T2D [5]. In Canada, women of reproductive age (18–45 years) have experienced the greatest increase in the incidence and prevalence of T2D and high blood pressure, dyslipidemia, and obesity (i.e., cardiovascular disease risk) are also elevated in this population [7–9]. Given these risks, pl
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