Lifestyle changes ‘too little, too late’ for averting gestational diabetes
medwireNews: Taking up healthy eating and exercise does not prevent obese pregnant women from developing gestational diabetes, despite having marked effects on weight gain, show the findings of a randomized trial.
“The intensive interventions, based on motivational interviewing, resulted in significant lifestyle improvements at both time periods of their assessment,” report the researchers in The Journal of Clinical Endocrinology & Metabolism.
As a result, by week 24–28 of pregnancy, the 97 women assigned to the healthy eating plus exercise group gained a significant 1.2 kg less than the 100 who received usual care, at 3.1 versus 4.3 kg. And by week 35–37, the difference was 2.3 kg, with corresponding weight gains of 6.5 and 8.8 kg among the respective 75 and 79 women still in the trial.
Women assigned to the healthy eating only and physical activity only groups gained an intermediate amount of weight, but closer to that seen in the control group.
Despite the reduced weight gain among women adopting both healthy eating and physical activity, there were no differences in the primary outcomes of fasting plasma glucose or insulin resistance. As a result, the proportion of women developing gestational diabetes in the intervention versus control groups did not significantly differ, at 20% versus 19% at the first timepoint and 32% versus 37% at the second timepoint.
A total of 436 women participated in the trial. They were aged an average of 32 years and entered the trial at an average of 15.3 weeks’ gestation, at which point they had an average body mass index of 34.5 kg/m2 but did not meet current criteria for gestational diabetes (IADPSG/WHO definition).
“Future studies might need even more intensive interventions, with greater support for women, leading to greater lifestyle changes,” suggest David Simmons (Western Sydney University, New South Wales, Australia) and co-researchers.
However, they note that although such interventions could have an impact, “the cost:benefit value will need to be assessed if the impact on [gestational diabetes] is limited, although the future health trajectory of both mother and child will also require analysis.”
medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2016