medwireNews: A postpartum lifestyle intervention may help women with gestational diabetes to lose weight following childbirth, indicate results from the 1-year analysis of the Tianjin Gestational Diabetes Mellitus Prevention Program (TGDMPP) randomized controlled trial.
“Women with [gestational diabetes] are seven times more likely to develop type 2 diabetes than those without,” and lifestyle interventions may be able to “prevent or delay type 2 diabetes risk among women with [gestational diabetes] during the early postpartum period,” say Gang Hu (Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA) and study co-authors.
To test this hypothesis, the TGDMPP investigators randomly assigned 1180 Chinese women with gestational diabetes to take part in a 4-year lifestyle intervention for the prevention of type 2 diabetes, the first year of which was a weight loss phase, or to receive usual care. The intervention – delivered a mean of 27.1 months after delivery – involved face-to-face consultations with dietitians, physical activity goals, and regular monitoring, whereas usual care included oral and written education about type 2 diabetes prevention.
At the 1-year follow-up, mean weight loss was 0.82 kg among the 460 participants in the intervention group who remained in the study, compared with 0.09 kg for the 470 patients in the control group, a significant difference.
Women receiving the lifestyle intervention also experienced a significantly greater decrease in waist circumference (1.76 vs 0.73 cm) and body fat (0.50% decrease vs 0.05% increase) than those in the control group.
Furthermore, prespecified subgroup analyses demonstrated that weight loss was “more pronounced” among women with higher bodyweight at baseline, report the researchers in Diabetes, Obesity and Metabolism.
In the subgroup of 406 participants with a BMI of at least 24 kg/m2 at baseline, women in the intervention group lost an average of 2.01 kg at the 1-year follow-up, compared with a loss of 0.44 kg for those in the control group.
Those with a BMI below 24 kg/m2 at baseline, however, did not lose weight during the first year of the intervention; participants in the intervention and control groups gained an average of 0.02 and 0.20 kg, respectively.
Taken together, these findings indicate that a lifestyle intervention given soon after delivery is feasible in women with gestational diabetes, conclude the researchers.
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