Women with gestational diabetes (GDM) have a 30-70% risk for developing type 2 diabetes. Although women with a GDM history can decrease their risk for type 2 diabetes through weight loss and physical activity, few evidence-based programs exist to help decrease their risk in the postpartum period. Women with recent GDM were randomized at ∼6 weeks postpartum to a web-based 12-month lifestyle intervention program or to a control website. We measured weight and administered behavioral questionnaires at 6 weeks, 6 months, and 12 months postpartum. Our study included 181 women (mean 33±5.3 years; 48% White, 22% Asian, 17% African-American, 13% other race, with 35% Hispanic). 31% of women reported household incomes <$35,000 per year. The mean BMI at the baseline study visit was 31 ± 6 kg/m2. Using a mixed effects model, at 12 months, women randomized to the intervention lost 1.4 kg vs. +1.1 kg in the control group (difference between groups -2.6 kg, 95% CI: -6.8 to +1.6, p=0.23). Retention at 12 months was over 85%. In a pre-planned subgroup analysis by ethnicity, non-Hispanic women in the intervention lost significantly more weight than non-Hispanic controls at 12 months (difference between groups of -5.8 kg, 95% CI: -10.9 to -0.6 kg, p=0.03). On the other hand, no significant weight difference between the intervention and control groups was seen at 12 months in Hispanic women (+2.9 kg, 95% CI: -3.2 to 9.1 kg, p=0.35). At 12 months postpartum, the Balance after Baby intervention program was associated with significant postpartum weight loss among non-Hispanic women, but not among Hispanic women. The Balance after Baby intervention program holds promise for decreasing diabetes risk factors in women with recent GDM. Analysis of the behavioral data may help explain the difference in weight outcome by ethnicity, and help guide future optimization of the intervention for Hispanic women.
J.M. Nicklas: None. G. Skurnik: None. A.T. Roche: None. C. Schultz: None. K. Suresh: None. E.W. Seely: None.
Centers for Disease Control and Prevention (HHSD2002013M53968B); National Institutes of Health (1K23HL133604); Colorado National Center for Advancing Translational Sciences (UL1TR001082, UL1TR001102)