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Postnatal Lifestyle Intervention for Overweight Women With Previous Gestational Diabetes: A Randomized Controlled Trial

医学 超重 妊娠期糖尿病 随机对照试验 减肥 2型糖尿病 物理疗法 肥胖 随机化 糖尿病 介绍 产科 儿科 怀孕 内科学 妊娠期 内分泌学 家庭医学 生物 遗传学
作者
Valerie Holmes,Claire R Draffin,Chris Patterson,Loraine Francis,Jo-anne Irwin,Mae McConnell,Brid Farrell,Sarah Brennan,Oonagh McSorley,Amy Wotherspoon,Mark Davies,David R. McCance
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [Oxford University Press]
卷期号:103 (7): 2478-2487 被引量:36
标识
DOI:10.1210/jc.2017-02654
摘要

Gestational diabetes mellitus (GDM) is associated with a sevenfold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. To determine the impact of a postnatal lifestyle intervention program for overweight women with previous gestational diabetes mellitus (PAIGE). Postnatal overweight women with previous GDM participated in a multicenter randomized controlled trial between June 2013 and December 2014. The intervention comprised a 1-hour educational program, a free 3-month referral to a commercial weight management organization (Slimming World), a pedometer, and structured telephone and text support, in addition to usual care. The control group received usual care only. The primary outcome was weight loss at 6 months. Sixty women were randomized (29 intervention; 31 control) in two centers based on their week of attendance. The intervention group demonstrated significant weight loss at 6 months after randomization compared with the control group: mean ±SD, 3.9 ± 7.0 kg vs 0.7 ±3.8 kg (P = 0.02). Blood glucose levels did not significantly differ. With respect to well-being measures, a bodily pain was significantly reduced in the intervention group (P = 0.007). PAIGE resulted in significantly greater weight loss at 6 months compared with usual care. Such weight loss could prove beneficial in terms of better long-term health and subsequent prevention of type 2 diabetes in overweight women with previous GDM. Future interventions must consider recruitment strategies, timing of the intervention, and inclusion of partners and/or other family members.

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