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A systematic review of gestational diabetes mellitus lifestyle interventions for weight loss and type 2 diabetes mellitus prevention in the United States for women following childbirth

Light, Morgan E
http://rave.ohiolink.edu/etdc/view?acc_num=osu1492187617463582

Abstract Details

2017, Master of Science, Ohio State University, Public Health.
Context: Several lifestyle interventions have been implemented to help women diagnosed with gestational diabetes mellitus (GDM) prevent type 2 diabetes mellitus (T2DM) in the 12-month period following childbirth. However, few interventions have taken place in the United States. In addition to being a costly problem in the United States, diabetes is especially burdensome on those suffering from its effects. Interventions that target GDM lifestyle changes for the sake of T2DM prevention for mothers will decrease the cost strain on the U.S. and, just as importantly, allow mothers to either start or get back to a healthy lifestyle while balancing the demands of motherhood. Data Sources: I searched for eligible articles using Cochrane Central Register of Controlled Trials and MEDLINE via PubMed, contacting experts, and searching bibliographies and abstracts. Search terms included “gestational diabetes mellitus,” “type 2 diabetes mellitus,” “lifestyle intervention,” “community intervention,” “United States,” and “postpartum period.” Study Selection: To be eligible, studies had to be conducted in the United States, have an intervention that started either within 12 months postpartum or during gestation and continued through 12 months postpartum, and targeted women with GDM. Results: Four studies were eligible, of which three had results available (the fourth is ongoing). Interventions were combinations of telephone sessions, email sessions, and workbooks. The three completed studies were adaptations of the Diabetes Prevention Program (DPP) meaning they used an intervention for diet and weight loss that was modeled after the DPP’s interventions for weight loss and diet. One study had an intervention that modestly reduced postpartum weight retention at 6 months only (mean 0.39 kg [SD 5.5] for intervention arm vs. 0.95 kg [5.5] for control arm; mean condition difference -0.64 kg [95% CI -1.13, -0.14]). Another study’s web-based intervention showed a moderate weight loss for the intervention arm of 2.8 kg (95% CI -4.8 to -0.7) from 6 weeks to 12 months postpartum whereas the control arm gained 4.0 kg during the same period (95% CI 1.3 to 6.8). A third study showed a non-statistically significant increase in the proportion of women who reached their postpartum weight goal (used here to measure weight reduction) in the intervention arm compared to the control arm at 12 months postpartum only, though not statistically significant (37.5% vs. 21.4%, absolute difference 16.1%, p=0.07). Limitations: The interventions, though modestly successful for two of the three studies with results, were intense for participants and researchers (interventions included several face-to-face meetings, workbooks, lifestyle coaches, web-based sessions, and telephone sessions) which calls sustainability of future similar interventions into question. Furthermore, two of the three included published studies failed to capture women in lower and middle-class, thus calling into question the population of women for whom the interventions’ results are applicable. A limitation of this review is that there was a small number of articles eligible for inclusion. However, the small number of available studies to analyze emphasizes an important research gap in GDM research. Conclusions: Researchers should consider interventions that include alternatives to a DPP adaptation for women diagnosed with GDM because current efforts such as interviews, telephone sessions, and workbooks either do not work, or work only when increasing the demand on participants, some of whom may be struggling to find time during a busy life stage.
Maria Gallo (Advisor)
38 p.
Epidemiology; Health; Medicine; Public Health

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Citations

  • Light, M. E. (2017). A systematic review of gestational diabetes mellitus lifestyle interventions for weight loss and type 2 diabetes mellitus prevention in the United States for women following childbirth [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492187617463582

    APA Style (7th edition)

  • Light, Morgan. A systematic review of gestational diabetes mellitus lifestyle interventions for weight loss and type 2 diabetes mellitus prevention in the United States for women following childbirth. 2017. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1492187617463582.

    MLA Style (8th edition)

  • Light, Morgan. "A systematic review of gestational diabetes mellitus lifestyle interventions for weight loss and type 2 diabetes mellitus prevention in the United States for women following childbirth." Master's thesis, Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492187617463582

    Chicago Manual of Style (17th edition)

osu1492187617463582
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