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Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis

Wubet Worku Takele, Kimberly K. Vesco, Jami Josefson, Leanne M. Redman, Wesley Hannah, Maxine P. Bonham, Mingling Chen, Sian C. Chivers, Andrea J. Fawcett, Jessica A. Grieger, Nahal Habibi, Gloria K.W. Leung, Kai Liu, Eskedar G. Mekonnen, Maleesa Pathirana, Alejandra Quinteros, Rachael Taylor, Gebresilasea G. Ukke, Shao J. Zhou, Paul W. FranksStephen S. Rich, Robert Wagner, Tina Vilsbøll (Member of author group), Miriam S. Udler, Tiinamaija Tuomi, Arianne Sweeting, Emily K. Sims, Jennifer L. Sherr, Robert K. Semple, Rebecca M. Reynolds, Maria J. Redondo, Richard E. Pratley, Rodica Pop-Busui, Toni I. Pollin, Wei Perng, Ewan R. Pearson, Susan E. Ozanne, Katharine R. Owen, Richard Oram, Rinki Murphy, Viswanathan Mohan, Shivani Misra, James B. Meigs, Nestoras Mathioudakis, John J. Nolan (Member of author group), Mathias Ried-Larsen (Member of author group), Torben Hansen (Member of author group), Christoffer Clemmensen (Member of author group), Mette K. Andersen (Member of author group), Anne Cathrine B. Thuesen (Member of author group), ADA/EASD PMDI

38 Citations (Scopus)

Abstract

Background: Lifestyle choices, metformin, and dietary supplements may prevent GDM, but the effect of intervention characteristics has not been identified. This review evaluated intervention characteristics to inform the implementation of GDM prevention interventions. Methods: Ovid, MEDLINE/PubMed, and EMBASE databases were searched. The Template for Intervention Description and Replication (TIDieR) framework was used to examine intervention characteristics (who, what, when, where, and how). Subgroup analysis was performed by intervention characteristics. Results: 116 studies involving 40,940 participants are included. Group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) reduce the incidence of GDM compared with individual or mixed (individual and group) delivery format (subgroup p-value = 0.04). Physical activity interventions delivered at healthcare facilities reduce the risk of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p-value = 0.03). No other intervention characteristics impact the effectiveness of all other interventions. Conclusions: Dietary, physical activity, diet plus physical activity, metformin, and myoinositol interventions reduce the incidence of GDM compared with control interventions. Group and healthcare facility-based physical activity interventions show better effectiveness in preventing GDM than individual and community-based interventions. Other intervention characteristics (e.g. utilization of e-health) don’t impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.

Original languageEnglish
Article number75
JournalCommunications medicine
Volume4
Issue number1
ISSN2730-664X
DOIs
Publication statusPublished - 20 Apr 2024

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