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Diabetes Care. 2016 Jan;39(1):24-30. doi: 10.2337/dc15-0511. Epub 2015 Jul 29.

Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): A Randomized Controlled Trial.

Author information

1
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, and Kätilöopisto Maternity Hospital, Helsinki, Finland saila.koivusalo@hus.fi.
2
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, and Kätilöopisto Maternity Hospital, Helsinki, Finland.
3
Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland Medical Genetics and Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
4
University of Eastern Finland, Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, Kuopio, Finland Helsinki and Uusimaa Hospital District, Helsinki, Finland Kuopio University Hospital, Kuopio, Finland.
5
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
6
Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
7
Turku University Hospital and Turku University, Turku, Finland.
8
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Jorvi Hospital, Espoo, Finland.
9
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Women's Hospital, Helsinki, Finland.
10
Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
11
Medical Genetics and Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
12
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland.
13
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
14
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland.
15
Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.

Abstract

OBJECTIVE:

To assess whether gestational diabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease.

RESEARCH DESIGN AND METHODS:

Two hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ≥30 kg/m(2) were enrolled in the study at <20 weeks of gestation and were randomly allocated to the intervention group (n = 155) or the control group (n = 138). Each subject in the intervention group received individualized counseling on diet, physical activity, and weight control from trained study nurses, and had one group meeting with a dietitian. The control group received standard antenatal care. The diagnosis of GDM was based on a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation.

RESULTS:

A total of 269 women were included in the analyses. The incidence of GDM was 13.9% in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (-0.58 kg [95% CI -1.12 to -0.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group.

CONCLUSIONS:

A moderate individualized lifestyle intervention reduced the incidence of GDM by 39% in high-risk pregnant women. These findings may have major health consequences for both the mother and the child.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01698385.

PMID:
26223239
DOI:
10.2337/dc15-0511
[Indexed for MEDLINE]

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