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Preventing Type 2 Diabetes after Gestational Diabetes

Gestational diabetes is a type of diabetes that develops during pregnancy that affects 2-10% of the pregnancies in the United States each year. Gestational diabetes typically goes away after the baby is born.1 However, women who have had gestational diabetes have a 3-7 times increased risk of developing type 2 diabetes within 5-10 years,2 and their child from that pregnancy has increased risk for both obesity and type 2 diabetes.1

The good news is that you can decrease the risk of developing type 2 diabetes after having had gestational diabetes. A study published in the New England Journal of Medicine in 2001 showed that people with pre-diabetes who lost 5-7% of their body weight and exercised a minimum of 150 minutes per week decreased their risk of developing type 2 diabetes by 58%.3 Even 10 years after making changes to their food choices and exercise habits, people who participated in a lifestyle change program were one-third less likely to develop type 2 diabetes.4

Key food choice strategies to decrease risk of developing type 2 diabetes

There isn’t one set diet that helps promote weight loss or prevents type 2 diabetes. However, a study published in 2012 that followed over 4,000 women with a history of gestational diabetes from the Nurses’ Health Study II found that women who chose a diet that contained more whole grains, fresh fruits, vegetables and legumes with moderate amounts of poultry, seafood and nuts while limiting red and processed meats like lunch meats, sausage and hot dogs reduced their risk of developing type 2 diabetes by half.5 Information from this large study also showed a correlation between drinking one or more sweetened beverages such as sweet tea, lemonade, soda, and fruit drinks per day with increased body weight as well as increased risk of developing type 2 diabetes.6 Our tips:

  • Choose 100% whole grain bread, cereal and crackers instead of more processed white and enriched products. Look for the word ‘whole’ in the first ingredient to be sure you’re choosing a food made from whole, less processed grains.
  • Enjoy fresh fruit as a naturally sweet snack instead of candy, ice cream or cookies.
  • Choose unsweetened frozen fruit or canned fruit packed in its own juice or water for desserts.
  • Include larger portions of fresh, frozen or canned vegetables than potato, rice, noodles or other types of starchy foods.
  • Choose skinless poultry and seafood more often than red meat. Bake, broil or grill instead of frying or deep-frying.
  • Enjoy meatless meals a few times per week by replacing animal meats like chicken or hamburger with lentils, black beans, pinto beans or other types of legumes that contain more beneficial fiber and less harmful saturated fat.
  • Avoid lunch meats and hot dogs and instead choose nut butter or less processed sliced turkey.
  • Make plain water your primary beverage.

Key exercise strategies

Exercise can help promote weight loss, and it also helps your body utilize insulin effectively to maintain healthy blood sugar levels. Aim for 30 minutes of physical activity most days of the week for the best benefits.7 Even shorter amounts of exercise give you benefits, so avoid falling into the trap of thinking that if you don’t have 30 minutes to exercise, it’s not worth it. Some exercise is always better than no exercise! Endurance types of exercise like walking, dancing, swimming, and riding a bike as well as strength exercises like weight training or circuit training help reduce insulin resistance that plays a large role in type 2 diabetes.3 Our tips:

  • Start slowly and gradually build up exercise over time doing any type of activity that you enjoy and keeps you moving such as walking, an exercise class, or playing outside with your children.
  • Make exercise part of your daily routine, such as taking a 10-minute walk during lunch or after dinner.
  • Break exercise into smaller segments that you spread throughout the day, such as a 5 minute brisk walk on your way to work, 5 minute walk at lunch, and 20 minutes exercise while watching TV.
  • Incorporate physical activity into your routine by parking further away and taking the stairs whenever possible.

In addition to healthy eating habits and regular exercise, the National Institutes of Health also recommends that women with gestational diabetes:8

  1. See your physician to have your blood sugar levels tested 6-12 weeks after the baby is born. Women who have had gestational diabetes should have their blood sugar levels tested every 3 years since type 2 diabetes usually develops gradually without symptoms.
  2. Breastfeeding your child not only can help you lose weight, it also helps decrease your blood sugar levels.
  3. Talk to your doctor if you plan to become pregnant again in the future since you are at higher risk for developing gestational diabetes.
  4. Tell your child’s doctor if you had gestational diabetes.
  5. Keep up healthy habits for a lifetime to prevent or delay type 2 diabetes.

By adopting these healthy strategies into your life you’ll positively influence the health of your children and family members. Since children born to women with gestational diabetes also have increased risk of being overweight or developing type 2 diabetes, establishing healthy eating and exercise habits is important for everyone in your family.


  1. Centers for Disease Control and Prevention. Gestational Diabetes. Last updated 7-25-17; accessed 10-20-18.
  2. Andrew Curry. Exploring Why Gestational Diabetes Leads to Type 2. Diabetes Forecast. January 2015.
  3. Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. Tuomilehto J et al. May 3, 2001. N Engl J Med 2001; 344:1343-1350  
  4. Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677-1686. doi:10.1016/S0140-6736(09)61457-4.
  5. Tobias DK, Hu FB, Chavarro J, Rosner B, Mozaffarian D, Zhang C. Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus. Arch Intern Med. 2012;172(20):1566-72.
  6. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004;292:927–34
  7. National Institute of Diabetes and Digestive and Kidney Diseases. Preventing Type 2 Diabetes. Published November 2016, accessed 10-30-18.
  8. National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Month 2018. Updated 7-25-17; accessed 10-21-18.