Eating a healthy diet may reduce the risk that women who go through pregnancy diabetes will develop type 2 diabetes later, a study finds. Some women develop gestational diabetes during pregnancy. The condition goes away after the birth. But these women are more likely than others to develop type 2 diabetes later. The study looked at information on 4,413 women who developed diabetes during pregnancy. The women were all part of a long-term study of nurses' health. During that study, they answered questions regularly about what they ate. For the new study, researchers divided the women into groups based on how healthy their diets were. Their diets were compared with 3 diet patterns that are all rich in whole grains, fresh fruits, vegetables and legumes. These diets include poultry, seafood and nuts. They limit red and processed meats. Of the women in the study, 491 later developed type 2 diabetes. Women who most closely followed the healthy diets were 40% to 59% less likely to develop diabetes than women who ate the least healthy diets. The journal Archives of Internal Medicine published the study online.

By Reena L. Pande, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

Staying healthy and losing weight after pregnancy can be a challenge. But following a healthy diet may be especially important for women who have gestational diabetes, or high blood sugars during pregnancy. For them, a healthy diet may lower the risk of developing diabetes later in life.

About 5 out of every 100 pregnant women will develop diabetes during their pregnancies. This adds up to about 200,000 cases each year in the United States.

Most women are tested for diabetes during the middle of pregnancy. The test involves checking blood sugar levels before and after drinking a sugary drink. If your blood sugar level is too high one or two hours after you have the drink, you may have gestational (pregnancy) diabetes. Having diabetes during pregnancy is bad for several reasons:

• Increased risk to the baby -- Babies born to mothers with diabetes may be larger than normal. They also may be at risk for low blood sugar (hypoglycemia) when they are born.
• Increased risk to the mother -- For many women, diabetes will go away after the baby is born. But having diabetes puts you at higher risk of developing type 2 diabetes later in life. And we know that diabetes greatly increases the risk of developing heart disease. This is a major cause of death in the United States. So anything we can do to limit this risk is critical.

A study in the journal Archives of Internal Medicine gives us hope that women with pregnancy diabetes can lower their risk of developing diabetes later in life. The key seems to be eating a healthy diet after pregnancy.

The study kept track of more than 4,400 women who had diabetes during pregnancy. They also were asked about their eating habits. During the next 14 years, about 1 in 10 of these women developed diabetes. However, those who ate a healthy diet had a much lower risk of diabetes. The three dietary patterns studied were:

• Mediterranean diet
• DASH diet (Dietary Approaches to Stop Hypertension)
• Healthy Eating Index

All of these diets have been linked with lower risks of diabetes and heart disease. In fact, women eating these healthy diets were able to cut their risk of diabetes by nearly one-half.

What Changes Can I Make Now?

If you have diabetes during pregnancy, first know that you need to take this seriously. It presents a risk for your baby now, and for your own health later. But the good news is that you have the power to change your behavior, get healthy and prevent yourself from getting diabetes later in life by eating right now. This is very important because diabetes increases your risk of heart disease, kidney disease and other problems you want to avoid.

What does "healthy eating" mean?

• Focus on a diet high in whole grains, beans and fresh fruits and vegetables.
• Avoid foods that contain much saturated fat.
• Eat "real food" before anyone else has had their hands on it. Avoid the processed stuff as much as possible.
• Cut down on sodium (salt).

And don’t forget to do other things that can help keep you healthy.

• Exercise regularly.
• Keep stress to a minimum.
• Don't smoke.
• Maintain a healthy body weight.

What Can I Expect Looking to the Future?

Studies like this one remind us that we do have the power to change our behavior to prevent diseases from developing. In the future, I hope that we see more research on how the medical system can help you get healthy and stay healthy. Research should focus on people who are at the greatest risk. Women with diabetes during pregnancy are one high-risk group.

For now, remember that it is critical to eat healthy after your pregnancy, lose weight and stay fit. This will help you to prevent diabetes from setting in later in life.