One‐year weight losses in the Tianjin Gestational Diabetes Mellitus Prevention Programme: A randomized clinical trial

Liu, Huikun; Wang, Leishen; Zhang, Shuang; Leng, Junhong; Li, Nan; Li, Weiqin; Wang, Jing; Tian, Hui; Qi, Lu; Yang, Xilin; Yu, Zhijie; Tuomilehto, Jaakko; Hu, Gang

doi:10.1111/dom.13225

Cited by 43 publications

(64 citation statements)

References 27 publications

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“…The remaining studies were carried out in Australia ( n = 1/14) [84], Canada ( n = 1/14) [85], Finland ( n = 1/14) [86], Ireland ( n = 1/14) [87], Spain ( n = 1/14) [88] and Thailand ( n = 1/14) [89]. Of these intervention studies, the large majority were randomized controlled trials (RCTs) ( n = 9/14) [76, 78, 79, 81, 82, 84, 87–89] and the remaining studies were intervention trials ( n = 5/14), with two of them ( n = 2/5) containing a control group [80, 83] and the other three ( n = 3/5) using a pre/post-test design [77, 85, 86]. The majority of the included studies were published between 2011 and 2015 ( n = 10/16) [76, 77, 81, 83–89], whereas the remaining studies were published between 2006 and 2010 ( n = 3/16) [74, 78, 80] and 2016–2018 ( n = 2/16) [75, 82].…”

Section: Resultsmentioning

confidence: 99%

How diet, physical activity and psychosocial well-being interact in women with gestational diabetes mellitus: an integrative review

Gilbert

Gross

Lanzi

et al. 2019

BMC Pregnancy Childbirth

120

100

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BackgroundGestational Diabetes Mellitus (GDM) is associated with future cardio-metabolic risks for the mother and her child. In addition, one-third of women with recent GDM develop postpartum depression. Given these adverse impacts of GDM on the health of the mother and her offspring, it is important to intervene on modifiable factors, such as diet, physical activity, and psychosocial well-being. This integrative review therefore explored evidence on how these modifiable factors interact in women with GDM and their offspring, and how effective combined interventions are on reducing adverse impacts of GDM.MethodsA comprehensive search strategy included carefully selected terms that corresponded to the domains of interest (diet, physical activity and psychosocial well-being). The databases searched for articles published between 1980 and February 2018 were: CINAHL, PsycINFO, Embase, Pubmed and Cochrane. Studies that were included in this review were either observational or intervention studies that included at least two domains of interest. Articles had to at least report data on maternal outcomes of women with GDM.ResultsThe search strategies identified 14′419 citations after excluding duplicates. After screening titles and then abstracts, 114 articles were selected for detailed evaluation of their full text, and 16 were included in this review: two observational and 14 intervention studies. Results from observational studies showed that psychosocial well-being (social support and self-efficacy) were positively associated with physical activity and dietary choice. Intervention studies always included diet and physical activity interventions, although none integrated psychosocial well-being in the intervention. These lifestyle interventions mostly led to increased physical activity, improved diet and lower stress perception. Many of these lifestyle interventions also reduced BMI and postpartum diabetes status, improved metabolic outcomes and reduced the risk of preterm deliveries and low birth weight.ConclusionThis integrative review showed that psychosocial well-being interacted with diet as well as with physical activity in women with GDM. We recommend that future studies consider integrating psychosocial well-being in their intervention, as observational studies demonstrated that social support and self-efficacy helped with adopting a healthy lifestyle following GDM diagnosis.Electronic supplementary materialThe online version of this article (10.1186/s12884-019-2185-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

How diet, physical activity and psychosocial well-being interact in women with gestational diabetes mellitus: an integrative review

Gilbert

Gross

Lanzi

et al. 2019

BMC Pregnancy Childbirth

120

100

View full text Add to dashboard Cite

show abstract

“…We then excluded 23 additional studies, remaining with a total of 15 studies. The reasons for exclusion were: not a randomized controlled trial ( n = 4) ( 30 – 33 ), not reporting our primary outcomes ( n = 13) ( 34 – 46 ), study population not meeting our inclusion criteria specification ( n = 4) ( 47 – 50 ) and different reports from the same study ( n = 2) ( 51 , 52 ).…”

Section: Resultsmentioning

confidence: 99%

Lifestyle Intervention for the Prevention of Diabetes in Women With Previous Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

et al. 2018

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Background: Type 2 diabetes is increasing among the young, and gestational diabetes (GDM) offers a unique opportunity for diabetes prevention. We aimed to systematically review postpartum randomized trials to summarize the benefits of lifestyle interventions for women with previous GDM.Methods:We searched for RCTs involving women with previous GDM that compared lifestyle interventions—diet, physical activity or breastfeeding—at postpartum with usual care up to May 2018.Results:Of 1,895 abstracts identified, we selected 15 studies investigating incidence of diabetes or changes in glycemia. Most interventions focused on changes in diet and physical activity, only one also on incentive to breastfeeding. Meta-analysis of 8 studies investigating incidence of diabetes revealed a homogeneous (I2 = 10%), reduction of 25% (RR = 0.75; 95%CI: 0.55–1.03) borderline statistically significant. Only trials offering intervention soon after delivery (< 6 months post-partum) were effective (RR = 0.61; 95%CI: 0.40–0.94; p for subgroup comparison = 0.11). Overall, no benefit was found regarding measures of glycemia. Although moderate reductions in weight (MD = −1.07 kg; −1.43−0.72 kg); BMI (MD = −0.94 kg/m2; −1.79 −0.09 kg/m2); and waist circumference (MD = −0.98 cm; −1.75 −0.21 cm) were observed, effects were larger with longer follow-up.Conclusions:Summary results of the available evidence support benefits of lifestyle interventions at postpartum for women with previous GDM. Benefits, although smaller than those of major trials based in older subjects receiving intensive interventions, appear clinically relevant for this young subset of woman. Further studies are needed to improve the quality of the evidence and to further tailor interventions to this specific setting.

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Section: Discussionmentioning

confidence: 99%

“…Although a successful lifestyle modification programme has the potential to reduce the risk of progression to diabetes, data are required to demonstrate its feasibility and scalability in resource-constrained environments. The LIVING study, along with other completed and ongoing studies of relevance summarized in Table 2, is designed to provide practical new evidence in this critical area of need [17][18][19]. Despite its strengths in multiple domains, this study may face challenges in terms of recruitment, engagement with programme, and retention for long term follow up, as has been observed in other similar recent published trials [17].…”

Section: % Of Participants Completed the Year 1 Trialmentioning

confidence: 99%

A lifestyle intervention programme for the prevention of Type 2 diabetes mellitus among South Asian women with gestational diabetes mellitus [LIVING study]: protocol for a randomized trial

et al. 2018

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Aim This study aims to determine whether a resource‐ and culturally appropriate lifestyle intervention programme in South Asian countries, provided to women with gestational diabetes (GDM) after childbirth, will reduce the incidence of worsening of glycaemic status in a manner that is affordable, acceptable and scalable. Methods Women with GDM (diagnosed by oral glucose tolerance test using the International Association of the Diabetes and Pregnancy Study Groups criteria) will be recruited from 16 hospitals in India, Sri Lanka and Bangladesh. Participants will undergo a repeat oral glucose tolerance test at 6 ± 3 months postpartum and those without Type 2 diabetes, a total sample size of 1414, will be randomly allocated to the intervention or usual care. The intervention will consist of four group sessions, 84 SMS or voice messages and review phone calls over the first year. Participants requiring intensification of the intervention will receive two additional individual sessions over the latter half of the first year. Median follow‐up will be 2 years. The primary outcome is the proportion of women with a change in glycaemic category, using the American Diabetes Association criteria: (i) normal glucose tolerance to impaired fasting glucose, or impaired glucose tolerance, or Type 2 diabetes; or (ii) impaired fasting glucose or impaired glucose tolerance to Type 2 diabetes. Process evaluation will explore barriers and facilitators of implementation of the intervention in each local context, while trial‐based and modelled economic evaluations will assess cost‐effectiveness. Discussion The study will generate important new evidence about a potential strategy to address the long‐term sequelae of GDM, a major and growing problem among women in South Asia. (Clinical Trials Registry of India No: CTRI/2017/06/008744; Sri Lanka Clinical Trials Registry No: SLCTR/2017/001; and ClinicalTrials.gov Identifier No: NCT03305939)

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One‐year weight losses in the Tianjin Gestational Diabetes Mellitus Prevention Programme: A randomized clinical trial

Abstract: The 1-year lifestyle intervention led to significant weight losses after delivery in women who had GDM, and the effect was more pronounced in women who were overweight at baseline.

Cited by 43 publications

References 27 publications

How diet, physical activity and psychosocial well-being interact in women with gestational diabetes mellitus: an integrative review

How diet, physical activity and psychosocial well-being interact in women with gestational diabetes mellitus: an integrative review

Lifestyle Intervention for the Prevention of Diabetes in Women With Previous Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

A lifestyle intervention programme for the prevention of Type 2 diabetes mellitus among South Asian women with gestational diabetes mellitus [LIVING study]: protocol for a randomized trial

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