Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot

David Simmons, Judith G M Jelsma, Sander Galjaard, Roland Devlieger, Andre van Assche, Goele Jans, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Lise Lotte Andersen, Annunziata Lapolla, Maria Dalfra, Alessandra Bertolotto, Ewa Wender-OzegowskaAgnieszka Zawiejska, David Hill, Pablo Rebollo, Frank J Snoek, Mireille N M van Poppel

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

OBJECTIVE: Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial.

RESEARCH DESIGN AND METHODS: Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35-37 weeks.

RESULTS: Among the 150 trial participants, 32% developed GDM by 35-37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (-2.6 kg [95% CI -4.9, -0.2]; P = 0.03) and lower fasting glucose (-0.3 mmol/L [-0.4, -0.1]; P = 0.01) than those in the PA group at 24-28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed.

CONCLUSIONS: An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind38
Udgave nummer9
Sider (fra-til)1650-6
Antal sider7
ISSN0149-5992
DOI
StatusUdgivet - sep. 2015

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  • Citationsformater

    Simmons, D., Jelsma, J. G. M., Galjaard, S., Devlieger, R., van Assche, A., Jans, G., Corcoy, R., Adelantado, J. M., Dunne, F., Desoye, G., Harreiter, J., Kautzky-Willer, A., Damm, P., Mathiesen, E. R., Jensen, D. M., Andersen, L. L., Lapolla, A., Dalfra, M., Bertolotto, A., ... van Poppel, M. N. M. (2015). Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot. Diabetes Care, 38(9), 1650-6. https://doi.org/10.2337/dc15-0360