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Diabetes Care. 2015 Sep;38(9):1650-6. doi: 10.2337/dc15-0360. Epub 2015 Jun 25.

Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot.

Author information

1
Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, U.K. University of Western Sydney, Campbelltown, NSW, Australia da.simmons@uws.edu.au.
2
Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
3
KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.
4
Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain.
5
Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
6
National University of Ireland, Galway, Ireland.
7
Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria.
8
Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
9
Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
10
Odense University Hospital, Odense, Denmark.
11
Universita Degli Studi di Padova, Padua, Italy.
12
Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
13
Department of Obstetrics and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland.
14
Recherche en Santé Lawson SA, Bronschhofen, Switzerland.
15
BAP Health Outcomes Research SL, Oviedo, Spain.
16
Department of Medical Psychology, VU University Medical Center and Academic Medical Center, Amsterdam, the Netherlands.

Abstract

OBJECTIVE:

Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial.

RESEARCH DESIGN AND METHODS:

Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35-37 weeks.

RESULTS:

Among the 150 trial participants, 32% developed GDM by 35-37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (-2.6 kg [95% CI -4.9, -0.2]; P = 0.03) and lower fasting glucose (-0.3 mmol/L [-0.4, -0.1]; P = 0.01) than those in the PA group at 24-28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed.

CONCLUSIONS:

An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

PMID:
26112044
DOI:
10.2337/dc15-0360
[Indexed for MEDLINE]

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