Lifestyle interventions help women with gestational diabetes return to healthy weight, study finds

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Supported lifestyle interventions is a generally successful way to help women with gestational diabetes manage their weight and remain active after giving birth, thereby reducing their risk of type 2 diabetes later in life. This is according to new research conducted at the Kaiser Permanente Northern California Division of Research.

The study, known as the Gestational Diabetes Effects on Moms study (GEM) could provide a solution to one of the biggest problems associated with gestational diabetes – the significantly increased risk of type 2 diabetes later in life. Studies suggest that women who have had gestational diabetes are seven times more likely to develop type 2 diabetes.

To offset the risk, the GEM study identified health-system-based methods to help women with gestational diabetes maintain a healthy weight after giving the birth. 1,087 women took part in the study, receiving coaching both via telephone (these sessions were conducted by a lifestyle coach) and through the post.

In the six months following the birth of their baby, women who received this specialised care were 45 per cent more likely to meet weight goals. They also took part in more exercise – on average, 15.4 minutes more per week.

Weight goals depended on the weight of the women before pregnancy. For those of a healthy weight pre-pregnancy, the weight goal was to return to their pre-pregnancy weight. For women who were overweight before pregnancy, the goal was to lose five per cent of their pre-pregnancy weight.

“The GEM study is unique in that it was a trial embedded in real-world practice. Our findings show the benefits of lifestyle intervention diabetes prevention programs in helping women with gestational diabetes manage their weight and increase physical activity, thereby potentially preventing or delaying the onset of diabetes,” said Assiamira Ferrara, MD, PhD, section chief of Women’s and Children Health at the Kaiser Permanente Northern California Division of Research, and lead author of the study.

Yvonne Crites, MD, perinatologist at Kaiser Permanente’s Santa Clara Medical Centre and medical director of the Perinatal Centre, added: “This study’s findings will inform how we help Kaiser Permanente members who had gestational diabetes reduce their chances of developing type 2 diabetes.”

The researchers believe that one the reasons the lifestyle interviews were a success was because “motivation interviewing”, the kind of coaching used in the telephone sessions, are tailored to the needs and preferences of the individual.

“Motivational interviewing is a patient-centred approach for encouraging behaviour change, which is increasingly applied in healthcare settings,” said study co-author Susan D. Brown, research scientist with the Kaiser Permanente Division of Research. “Lifestyle coaches help women identify their own reasons for making changes in their eating and exercise habits.”

Study co-author Monique M. Hedderson, research scientist with the Kaiser Permanente Division of Research, believes that “[t]his suggests a potential for great impact if we can improve patient engagement and participation in such lifestyle interventions.”

The findings are published in Diabetes Care.