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Lifestyle intervention promotes weight loss after gestational diabetes
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Women with a history of gestational diabetes who participated in a postnatal lifestyle intervention program experienced greater weight loss at 6 months compared with women who received usual care, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
“The National Institute for Health and Care Excellence (NICE) recently concluded that additional studies are urgently needed to assess the effectiveness and cost-effectiveness of weight management interventions after childbirth to prevent the development of type 2 diabetes following gestational diabetes,” researchers wrote. “In addition, questions remain in relation to the role of diet, physical exercise, group and individualized therapy.”
Valerie Holmes, Ph D , senior lecturer at the Centre for Public Health, Queen’s University Belfast, and colleagues evaluated data from 60 women with overweight and a history of gestational diabetes during recent pregnancy (mean age, 34 years; BMI, 34 kg/m2). Researchers randomly assigned 29 of the women to the intervention group and the remaining women to the control group. The study was conducted from June 2013 to December 2014. Primary outcome was weight loss at 6 months.
The intervention program, administered in small group sessions in a hospital setting, was adapted from the Diabetes Prevention Program (DPP) Lifestyle Intervention and based on a person-centered philosophy to encourage lifestyle change. Participants took part in a 1-hour educational program at an early postpartum office visit and received a 3-month referral to a U.K.-based weight-loss organization, a pedometer and supportive messages. The participants in the control group received usual care.
At 6 months, weight loss was greater in the intervention group compared with the control group (3.9 kg vs. 0.7 kg; P = .02), as were reductions in BMI and waist circumference. The intervention group reported considerably higher rates of physical activity and less body pain compared with the control group. No statistically significant differences in blood glucose levels were observed between the groups.
Additionally, the researchers noted a high nonattendance rate.
“Sixty women declined to participate in the study for reasons, which included time constraints, unavailability of child care or they did not want to leave their baby.” The researchers wrote. “This highlights the recognized barriers faced by women in the postpartum period regarding participation in a lifestyle intervention. All of these factors will need careful consideration in future research.” – by Jennifer Hoffman
Disclosures: This research was funded by the Public Health Agency, North Ireland. The authors report no relevant financial disclosures.