Individual research recommendation details

Recommendation ID

NG3/5

Question

Are there effective long-term pharmacological interventions to prevent the onset of type 2
diabetes that can be recommended postnatally for women who have been diagnosed with
gestational diabetes?

Any explanatory notes
(if applicable)

Gestational diabetes is one of the strongest risk factors for the subsequent development of type 2
diabetes: up to 50% of women diagnosed with gestational diabetes develop type 2 diabetes within
5 years of the birth. There are some data suggesting that changes in diet and exercise, with or
without metformin, can prevent type 2 diabetes developing in non-pregnant middle-aged people
with glucose intolerance, but there are no studies specifically in women with a past history of
gestational diabetes. There is thus an urgent need to investigate what interventions may delay or
prevent type 2 diabetes developing in this high-risk population of women. Undertaking a formal
randomised controlled trial involving long-term outcomes is often not feasible in practice.
However, it would be possible to have a quasi-randomised study comparing 2 populations of
women with similar demographic profiles who had gestational diabetes. One population would be
encouraged at their annual check to follow a specific diet and exercise regime and those in the
other population would not. The incidence of the development of type 2 diabetes in the 2 groups at
5, 10 and 20 years would be compared.

Source guidance details

Comes from guidance

Diabetes in pregnancy: management from preconception to the postnatal period

Number

NG3

Date issued

February 2015

Other details