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
Simmons, David (University of Western Sydney)
Jelsma, Judith G. M (Amsterdam University Medical Center (UMC))
Galjaard, Sander (University Hospitals Leuven (Bèlgica))
Devlieger, Roland (University Hospitals Leuven (Bèlgica))
Van Assche, Andre (University Hospitals Leuven (Bèlgica))
Jans, Goele (University Hospitals Leuven (Bèlgica))
Corcoy i Pla, Rosa (Institut d'Investigació Biomèdica Sant Pau)
Adelantado, Juan M (Institut d'Investigació Biomèdica Sant Pau)
Dunne, Fidelma (National University of Ireland)
Desoye, Gernot (Medizinische Universitaet Graz (Àustria))
Harreiter, Jürgen (Medical University of Vienna)
Kautzky-Willer, Alexandra (Medical University of Vienna)
Damm, Peter (University of Copenhagen)
Mathiesen, Elisabeth Reinhardt (University of Copenhagen)
Jensen, Dorte M. (Odense University Hospital (Dinamarca))
Andersen, Lise-Lotte (Odense University Hospital (Dinamarca))
Lapolla, Annunziata (Universita degli Studi di Padova (Itàlia))
Dalfra, Maria (Universita degli Studi di Padova (Itàlia))
Bertolotto, Alessandra (Azienda Ospedaliero-Universitaria Pisana)
Wender-Ozegowska, Ewa (Poznan University of Medical Sciences (Polònia))
Zawiejska, Agnieszka (Poznan University of Medical Sciences (Polònia))
Hill, David (Recherche en Santé Lawson SA (Suïssa))
Rebollo Álvarez, Pablo (BAP Health Outcomes Research SL (Oviedo, Espanya))
Snoek, Frank J. (VU University Medical Center and Academic Medical Center (Països Baixos))
Van Poppel, Mireille N.M. (Amsterdam University Medical Center (UMC))
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2015
Resum:	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/m) 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 (22. 6 kg [95% CI 24. 9, 20. 2]; P = 0. 03) and lower fasting glucose (20. 3mmol/L [20. 4,20. 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 comparedwith PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adult ; Diabetes, Gestational ; Europe ; Feeding Behavior ; Female ; Glucose Tolerance Test ; Humans ; Insulin Resistance ; Life Style ; Motivational Interviewing ; Motor Activity ; Obesity ; Pilot Projects ; Pregnancy ; Risk Reduction Behavior ; Weight Gain
Publicat a:	Diabetes Care, Vol. 38 Núm. 9 (september 2015) , p. 1650-1656, ISSN 1935-5548

DOI: 10.2337/dc15-0360
PMID: 26112044

7 p, 1.1 MB

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