1431-P: Intuitive Eating in Pregnancy Is Associated with BMI, Fasting Glucose, and A1c at One-Year Postpartum in Women with GDM: A Cohort Study

In women with GDM, there is a need to investigate novel lifestyle approaches to reduce the risk of future diabetes. Intuitive eating (IE) is an adaptive eating behavior where individuals accurately interpret and adhere to instinctive feedback regarding the required amount and timing of food. We evaluated the associations between IE during and after pregnancy with BMI, fasting glucose and A1c at 1-year postpartum (PP) in 117 women with GDM and in high-risk GDM subgroups with PP prediabetes or overweight/obesity. Women with GDM who consented and completed the “Eating for Physical rather than Emotional Reasons (EPR)” and “Reliance on Hunger and Satiety cues (RHSC)” subscales of the validated Intuitive Eating Scale-2 questionnaire during the first GDM clinic visit at 24-32 weeks of gestation and at 1-year PP were included. Participants mean age was 33.21±5.37 years, weight and BMI before pregnancy and at 1-year PP were 69.46±13.99kg, 25.82±4.69kg/m² and 72.79±16.22kg, 27.06±5.54kg/m² respectively, and the prevalence of prediabetes at 1-year PP was 46.2%. EPR at the first GDM visit predicted lower BMI (β=-0.219, p=0.017) and fasting glucose (β=-0.229, p=0.014) at 1-year PP, while associations were not significant for RHSC. At 1-year PP, EPR and RHSC were inversely associated with BMI (β=-0.243 to -0.337, both p≤ 0.012), whereas EPR was inversely associated with A1c and fasting glucose (β=-0.216 to -0.222, both p=0.018). In the subgroup of women with prediabetes, EPR and RHSC at the first GDM visit predicted lower fasting glucose at 1-year PP, while in the overweight/obese subgroup this was only significant for EPR (all p≤0.02). At 1-year PP however, both EPR and RHSC were inversely associated with BMI in women with prediabetes and with fasting glucose in overweight/obese women (all p≤0.03). No associations were found in low-risk GDM subgroups. Higher adherence to IE could represent a novel approach for PP BMI and glycemic control in women with previous GDM.