We sought to identify self-reported exercise and objectively measured fitness variables associated with glucose tolerance and metabolic health 6–10 years after gestational diabetes (GDM)

Women (n = 84) underwent oral glucose tolerance testing (OGTT), body composition measurements, and lifestyle questionnaires 6 and 10 years after GDM. In a subset (n = 45), peak oxygen uptake (VO_2peak), peak fat oxidation, and maximal isometric strength of five muscle groups were tested.

At 10 years, 41 women (49%) had impaired glucose metabolism or type 2 diabetes (T2D). VO_2peak and muscle strength were lowest in the T2D group. In a regression analysis, VO_2peak and all strength measurements were associated negatively with HbA1c and waist-hip ratio and positively with high-density lipoprotein cholesterol. However, only muscle strength was associated with fasting and area-under-the-curve glucose. For changes between the 6- and 10-year follow-ups, only muscle strength was associated with HbA1c change, whereas both VO_2peak and strength were associated with high-density lipoprotein level and changes in waist-hip ratio. Peak fat oxidation and self-reported physical activity showed no or weak relationships with glycemic variables.

Objectively measured fitness variables, particularly muscle strength, were strongly associated with glycemic and other metabolic outcomes in a high-risk group after GDM.