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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Association between Gestational Weight Gain, Gestational Diabetes Risk, and Obstetric Outcomes: A Randomized Controlled Trial Post Hoc Analysis

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  1. Diabetes Management During Breastfeeding in Women with Type 1 Diabetes

    Research output: Contribution to journalReviewResearchpeer-review

  2. Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Gestational Diabetes Risk in Migrants. A Nationwide, Register-Based Study of all Births in Denmark 2004 to 2015

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  • David Simmons
  • Roland Devlieger
  • Andre van Assche
  • Sander Galjaard
  • Rosa Corcoy
  • Juan M Adelantado
  • Fidelma Dunne
  • Gernot Desoye
  • Alexandra Kautzky-Willer
  • Peter Damm
  • Elisabeth R Mathiesen
  • Dorte M Jensen
  • Lise Lotte T Andersen
  • Annunziata Lapolla
  • Maria G Dalfra
  • Alessandra Bertolotto
  • Ewa Wender-Ozegowska
  • Agnieszka Zawiejska
  • David Hill
  • Frank J Snoek
  • Mireille N M van Poppel
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Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m² <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24⁻28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35⁻37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester.

Original languageEnglish
JournalNutrients
Volume10
Issue number11
Pages (from-to)1568
Number of pages13
ISSN2072-6643
DOIs
Publication statusPublished - 23 Oct 2018

ID: 56081446