Women with GDM are 7 times more likely to develop type 2 diabetes later in life than parous women without GDM. Thus, interventions to improve lifestyle behaviors among women with GDM are urgently needed. In a randomized controlled trial, we tested a DPP-based intervention to help women with GDM make long-term healthy lifestyle changes and manage weight after pregnancy. Of 352 participants, 178 were randomized to standard care and 174 were randomized to a lifestyle intervention of individual sessions with a coach trained in motivational interviewing, which provided specific diet, physical activity and weight goals. The intervention consisted of a pregnancy phase (1 in-person session and 2 telephone sessions), an early postpartum phase (2 in-person sessions and 11 telephone sessions up to 6 months postpartum), and a late postpartum phase (6 maintenance newsletters up to 12 months postpartum). Participants were followed from pregnancy (shortly after GDM diagnosis) to 24 months postpartum. On average, over the 24-month postpartum period, women in the intervention reported greater reductions in daily total energy intake (mean changes [95% CI]: 103.5 [-206.8 to -0.2] kcal) and percent of calories from fat (-1.6 [-2.7 to -0.4]) than women in standard care. Women in the intervention also reported greater increases in MET hours/week of moderate-intensity sports activity at 6 months postpartum (1.98 [-0.24 to 4.20]); however, this difference did not persist at 24 months postpartum (1.00 [-1.64 to 3.65]). On average, over the 24-month postpartum period, there was no difference between conditions in mean weight change (-0.09 [-1.12 to 0.94] kg). A 12-month, translational DPP-based intervention delivered primarily via telephone improved diet and physical activity, but did not impact weight, at 24 months postpartum.
M.M. Hedderson: None. S.D. Brown: None. J. Feng: None. C. Quesenberry: None. A. Ferrara: None.
National Institutes of Health