Postnatal Lifestyle Intervention For Overweight Women With Previous Gestational Diabetes: A Randomized Controlled Trial

BackgroundGestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity.ObjectiveTo determine the impact of a postnatal lifestyle intervention programme for overweight women with previous gestational diabetes mellitus (PAIGE).DesignPostnatal overweight women with previous GDM participated in a multi-center randomized controlled trial between June 2013 and December 2014. The intervention comprised a one-hour educational programme, a free three-month referral to a commercial weight management organization (Slimming World), a pedometer and structured telephone and text support, in addition to usual care. The control group received usual care only. The primary outcome was weight loss at 6 months.ResultsA total of 60 women were randomized (29 intervention; 31 control) in two centers based on their week of attendance. The intervention group demonstrated significant weight loss at 6 months post-randomization: mean (SD) 3.9(±7.0)kg, compared with the control group: mean 0.7(±3.8)kg, p=0.02. No significant difference was observed in blood glucose levels. With respect to wellbeing measures, a significant reduction in bodily pain was observed in the intervention group (P=0.007).ConclusionsPAIGE resulted in significantly greater weight loss at 6 months compared with usual care. Such weight loss could prove beneficial in terms of better long-term health and subsequent prevention of type 2 diabetes in overweight women with previous GDM. Future interventions need to consider recruitment strategies, timing of the intervention and the inclusion of partners and/or other family members.