TY - JOUR
T1 - Effect of physical activity and/or healthy eating on GDM risk
T2 - The DALI Lifestyle Study
AU - Simmons, David
AU - Devlieger, Roland
AU - van Assche, André
AU - Jans, Goele
AU - Galjaard, Sander
AU - Corcoy, Rosa
AU - Adelantado, Juan M
AU - Dunne, Fidelma
AU - Desoye, Gernot
AU - Harreiter, Jürgen
AU - Kautzky-Willer, Alexandra
AU - Damm, Peter
AU - Mathiesen, Elisabeth R
AU - Jensen, Dorte M
AU - Andersen, Liselotte
AU - Lapolla, Annunziata
AU - Dalfrà, Maria G
AU - Bertolotto, Alessandra
AU - Wender-Ozegowska, Ewa
AU - Zawiejska, Agnieszka
AU - Hill, David
AU - Snoek, Frank J
AU - Jelsma, Judith Gm
AU - van Poppel, Mireille Nm
PY - 2017
Y1 - 2017
N2 - CONTEXT: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results.OBJECTIVE: The aim of this study was to compare the effectiveness of three lifestyle interventions (Healthy eating (HE), Physical activity (PA) and both HE and PA (HE+PA)) with usual care (UC) in reducing GDM risk.DESIGN: Multicentre Randomised Controlled Trial 2012-2014: The Dali Lifestyle Study Setting: Antenatal clinics across 11 centres in 9 European countries Patients: Consecutive pregnant women <20 weeks gestation with a BMI≥29 kg/m(2) and without GDM by IADPSG criteria (n=436).INTERVENTION: Women were randomized, stratified by site, to Control, HE, PA or HE+PA. Women received 5 face-to-face and up to 4 telephone coaching sessions, based on the principles of motivational interviewing. Gestational weight gain (GWG) <5kg was targeted. Coaches received standardized training and an intervention toolkit tailored to their culture/language.MAIN OUTCOME MEASURES: GWG at 35-37 weeks, fasting glucose and insulin sensitivity (HOMA-IR) at 24-28 weeks.RESULTS: We randomized 108 women to HE&PA, 113 to HE, 110 to PA and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially less GWG than controls by 35-37 weeks (-2.02 (95% CI -3.58; -0.46 kg). Despite this reduction there were no improvements in fasting or post-load glucose or,insulin concentrations or HOMA-IR. Birthweight, large and small for gestational age rates were similar.CONCLUSIONS: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycaemia. Lifestyle change alone is unlikely to prevent GDM among women with a BMI≥29 kg/m(2).
AB - CONTEXT: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results.OBJECTIVE: The aim of this study was to compare the effectiveness of three lifestyle interventions (Healthy eating (HE), Physical activity (PA) and both HE and PA (HE+PA)) with usual care (UC) in reducing GDM risk.DESIGN: Multicentre Randomised Controlled Trial 2012-2014: The Dali Lifestyle Study Setting: Antenatal clinics across 11 centres in 9 European countries Patients: Consecutive pregnant women <20 weeks gestation with a BMI≥29 kg/m(2) and without GDM by IADPSG criteria (n=436).INTERVENTION: Women were randomized, stratified by site, to Control, HE, PA or HE+PA. Women received 5 face-to-face and up to 4 telephone coaching sessions, based on the principles of motivational interviewing. Gestational weight gain (GWG) <5kg was targeted. Coaches received standardized training and an intervention toolkit tailored to their culture/language.MAIN OUTCOME MEASURES: GWG at 35-37 weeks, fasting glucose and insulin sensitivity (HOMA-IR) at 24-28 weeks.RESULTS: We randomized 108 women to HE&PA, 113 to HE, 110 to PA and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially less GWG than controls by 35-37 weeks (-2.02 (95% CI -3.58; -0.46 kg). Despite this reduction there were no improvements in fasting or post-load glucose or,insulin concentrations or HOMA-IR. Birthweight, large and small for gestational age rates were similar.CONCLUSIONS: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycaemia. Lifestyle change alone is unlikely to prevent GDM among women with a BMI≥29 kg/m(2).
U2 - 10.1210/jc.2016-3455
DO - 10.1210/jc.2016-3455
M3 - Journal article
C2 - 27935767
SN - 0021-972X
VL - 102
SP - 903
EP - 913
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
IS - 3
ER -