Journal article
Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study
JAMA internal medicine, Vol.174(7), pp.1047-1055
07/2014
DOI: 10.1001/jamainternmed.2014.1795
PMCID: PMC4209161
PMID: 24841449
Abstract
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.
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.
Prospective 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.
Physical activity and television watching and other sedentary behaviors were assessed in 1991, 1997, 2001, and 2005.
Incident T2DM identified through self-report and confirmed by supplemental questionnaires.
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.
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.
Details
- Title: Subtitle
- Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study
- Creators
- Wei Bao - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MarylandDeirdre K Tobias - Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MassachusettsKatherine Bowers - Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OhioJorge Chavarro - Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts4Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsAllan Vaag - Department of Endocrinology, Rigshospitalet, Copenhagen, DenmarkLouise Groth Grunnet - Department of Endocrinology, Rigshospitalet, Copenhagen, DenmarkMarin Strøm - Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, DenmarkJames Mills - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MarylandAiyi Liu - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MarylandMichele Kiely - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MarylandCuilin Zhang - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
- Resource Type
- Journal article
- Publication Details
- JAMA internal medicine, Vol.174(7), pp.1047-1055
- DOI
- 10.1001/jamainternmed.2014.1795
- PMID
- 24841449
- PMCID
- PMC4209161
- NLM abbreviation
- JAMA Intern Med
- ISSN
- 2168-6106
- eISSN
- 2168-6114
- Publisher
- United States
- Grant note
- ZIA HD008916-01 / Intramural NIH HHS P30 DK46200 / NIDDK NIH HHS HHSN275201000020C / NICHD NIH HHS UM1 CA176726 / NCI NIH HHS P30 DK046200 / NIDDK NIH HHS CA50385 / NCI NIH HHS R01 CA050385 / NCI NIH HHS HHSN275201000020C / PHS HHS R01 DK058845 / NIDDK NIH HHS DK58845 / NIDDK NIH HHS
- Language
- English
- Date published
- 07/2014
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9983996064002771
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