Journal
ACTA DIABETOLOGICA
Volume 57, Issue 12, Pages 1453-1462Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s00592-020-01553-1
Keywords
Gestational diabetes; Heterogeneity; Type 2 diabetes; Physical activity; Diet
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Funding
- Finnish Medical Foundation
- Alfred Kordelin Foundation
- Juho Vainio Foundation
- Ahokas Foundation
- Finnish Foundation for Cardiovascular Disease
- Special state subsidy for health science research of Helsinki University Hospital (HUH)
- Samfundet Folkhalsan
- Finska Lakaresallskapet
- Viipuri Tuberculosis Foundation
- Finnish Diabetes Research Foundation
- State Provincial Office of Southern Finland
- Health Promotion Grant (Ministry of Social Affairs and Health) EU H2020-PHC-2014-DynaHealth [633595]
- Social Insurance Institution of Finland
- Academy of Finland
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Aim Women with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI. Methods The RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI >= 30 kg/m(2)and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m(2). Results Altogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c. Conclusion Lifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women.
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