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Open Access 30-04-2022 | Gestational Diabetes | Article

Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes

Authors: Emilia Huvinen, Jari Lahti, Miira M. Klemetti, Paula H. Bergman, Katri Räikkönen, Marju Orho-Melander, Hannele Laivuori, Saila B. Koivusalo

Published in: Diabetologia | Issue 8/2022

Abstract

Aims/hypothesis

The aim of this study was to assess the interaction between genetic risk and lifestyle intervention on the occurrence of gestational diabetes mellitus (GDM) and postpartum diabetes.

Methods

The RADIEL study is an RCT aimed at prevention of GDM and postpartum diabetes through lifestyle intervention. Participants with a BMI ≥30 kg/m² and/or prior GDM were allocated to intervention and control groups before pregnancy or in early pregnancy. The study visits took place every 3 months before pregnancy, once in each trimester, and at 6 weeks and 6 and 12 months postpartum. We calculated a polygenic risk score (PRS) based on 50 risk variants for type 2 diabetes.

Results

Altogether, 516 participants provided genetic and GDM data. The PRS was associated with higher glycaemic levels (fasting glucose and/or HbA_1c) and a lower insulin secretion index in the second and third trimesters and at 12 months postpartum, as well as with a higher occurrence of GDM and glycaemic abnormalities at 12 months postpartum (n = 356). There was an interaction between the PRS and lifestyle intervention (p=0.016 during pregnancy and p=0.024 postpartum) when analysing participants who did not have GDM at the first study visit during pregnancy (n = 386). When analysing women in tertiles according to the PRS, the intervention was effective in reducing the age-adjusted occurrence of GDM only among those with the highest genetic risk (OR 0.37; 95% CI 0.17, 0.82). The risk of glycaemic abnormalities at 12 months postpartum was reduced in the same group after adjusting additionally for BMI, parity, smoking and education (OR 0.35; 95% CI 0.13, 0.97).

Conclusions/interpretation

Genetic predisposition to diabetes modifies the response to a lifestyle intervention aimed at prevention of GDM and postpartum diabetes. This suggests that lifestyle intervention may benefit from being tailored according to genetic risk.

Clinical trial registration

ClinicalTrials.gov identifier: NCT01698385

Graphical abstract

Available only for authorised users

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Title: Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes
Authors: Emilia Huvinen
Jari Lahti
Miira M. Klemetti
Paula H. Bergman
Katri Räikkönen
Marju Orho-Melander
Hannele Laivuori
Saila B. Koivusalo
Publication date: 30-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Gestational Diabetes
Gestational Diabetes
Type 2 Diabetes
Published in: Diabetologia / Issue 8/2022
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-022-05712-7

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Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Clinical trial registration

Graphical abstract

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

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