Interventions to modify the progression to type 2 diabetes mellitus in women with gestational diabetes: a systematic review of literature

Curr Opin Obstet Gynecol. 2014 Dec;26(6):476-86. doi: 10.1097/GCO.0000000000000127.


Purpose of review: Gestational diabetes mellitus (GDM) increases the lifetime risk of developing type 2 diabetes mellitus (T2DM) in the mother. We undertook a systematic review to assess the effectiveness of interventions that delay or prevent the onset of T2DM in women with previous gestational diabetes.

Recent findings: Diet and lifestyle interventions show differing effects on women with GDM and their long-term risk of T2DM. Pharmacological interventions, such as metformin, appear to have a beneficial role. Breastfeeding may have a protective role by reducing the risk of progression to T2DM. The findings were limited by the small number of heterogeneous studies that varied in their population, intervention, outcome and duration of follow-up.

Summary: Women with GDM should be informed about the future risk of T2DM and the potential benefit with lifestyle interventions. Further studies are needed prior to routine use of metformin as a preventive strategy for T2DM in women with GDM.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Breast Feeding
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes, Gestational / physiopathology
  • Diabetes, Gestational / therapy*
  • Diet, Diabetic
  • Disease Progression
  • Evidence-Based Medicine*
  • Female
  • Health Promotion
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Life Style
  • Metformin / therapeutic use
  • Motor Activity
  • Nutrition Policy
  • Patient Education as Topic
  • Pregnancy
  • Risk


  • Hypoglycemic Agents
  • Metformin