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Post-delivery lifestyle intervention can help women with gestational diabetes forestall diabetes

Posted:  Tuesday, December 08, 2015

Diabetes has cast its dark shadow on all, afflicting children, adults and pregnant women alike. While efforts are on worldwide to curb this growing menace of a disease, a new study has come up with some encouraging data. The study showed that participation in a post-delivery diabetes prevention programme can help women with a history of gestational diabetes to achieve weight loss goals and increase physical activity.

The study termed Gestational Diabetes Effects on Moms study (or GEM) was published online in the journal Diabetes Care. The study looked at health-system-based ways for helping women with gestational diabetes achieve their weight loss targets in the year after delivery. The post-delivery weight goals were different for normally weighted and overweight or obese women; the former were expected to return to their pre-pregnancy weight, while the latter were expected to lose 5 percent of their pre-pregnancy weight.

Gestational diabetes occurs during pregnancy and is characterised by high blood sugar levels. Women with this condition are up to 7 times more likely to develop type 2 diabetes in the years following delivery. Overweight or obesity is a recognised risk factor for type 2 diabetes.

For the study, the researchers offered a lifestyle intervention to 1,087 women with gestational diabetes at 22 medical clinics in Kaiser Permanente's Northern California Region. Another group of 1,193 women with gestational diabetes at 22 medical clinics were given printed materials with information on diabetes risk and its prevention. The women assigned the lifestyle intervention received mails about their pregnancy weight gain and a lifestyle workbook. They were also allowed to participate in 13 telephone sessions (conducted between six weeks and six months post delivery) with a lifestyle coach skilled in motivational interviewing.

During the six months post delivery, women in the lifestyle intervention group were 45 percent more likely to meet their weight loss goals than the women assigned to usual care (31% versus 24%, respectively). The intervention group also displayed increased vigorous-intensity physical activity by an average of 15.4 minutes per week.

Of all the women offered the lifestyle intervention, 50% of them agreed to participate in the programme. The researchers were intrigued to find that the intervention's efficacy would have doubled if all the 1,087 women had participated in the programme. They also found that the number of women who attained weight loss goals grew with the number of coaching sessions that they undertook.

Summarising the study’s findings, Assiamira Ferrara, MD, PhD, the study's lead author and section chief of Women's and Children's Health at the Kaiser Permanente Northern California Division of Research said, "The GEM study is unique in that it was a trial embedded in real-world practice. Our findings show the benefits of lifestyle intervention diabetes prevention programmes in helping women with gestational diabetes manage their weight and increase physical activity, thereby potentially preventing or delaying the onset of diabetes".

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