Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/199831 |
Resumo: | Background: Type 2 diabetes is increasing among the young, and gestational diabetes (GDM) offers a unique opportunity for diabetes prevention. We aimed to systematically review postpartum randomized trials to summarize the benefits of lifestyle interventions for women with previous GDM. Methods: We searched for RCTs involving women with previous GDM that compared lifestyle interventions—diet, physical activity or breastfeeding—at postpartum with usual care up to May 2018. Results: Of 1,895 abstracts identified, we selected 15 studies investigating incidence of diabetes or changes in glycemia. Most interventions focused on changes in diet and physical activity, only one also on incentive to breastfeeding. Meta-analysis of 8 studies investigating incidence of diabetes revealed a homogeneous (I2 = 10%), reduction of 25% (RR = 0.75; 95%CI: 0.55–1.03) borderline statistically significant. Only trials offering intervention soon after delivery (<6 months post-partum) were effective (RR = 0.61; 95%CI: 0.40–0.94; p for subgroup comparison = 0.11). Overall, no benefit was found regarding measures of glycemia. Although moderate reductions in weight (MD = −1.07 kg; −1.43−0.72 kg); BMI (MD = −0.94 kg/m2; −1.79 −0.09 kg/m2); and waist circumference (MD = −0.98 cm; −1.75 −0.21 cm) were observed, effects were larger with longer follow-up. Conclusions: Summary results of the available evidence support benefits of lifestyle interventions at postpartum for women with previous GDM. Benefits, although smaller than those of major trials based in older subjects receiving intensive interventions, appear clinically relevant for this young subset of woman. Further studies are needed to improve the quality of the evidence and to further tailor interventions to this specific setting. |
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Goveia, PâmellaCañon-Montañez, WilsonSantos, Danilo de PaulaLopes, Gabriela WünschMa, Ronald Ching WanDuncan, Bruce BartholowZiegelmann, Patricia KlarmannSchmidt, Maria Inês2019-09-28T03:47:41Z20181664-2392http://hdl.handle.net/10183/199831001099953Background: Type 2 diabetes is increasing among the young, and gestational diabetes (GDM) offers a unique opportunity for diabetes prevention. We aimed to systematically review postpartum randomized trials to summarize the benefits of lifestyle interventions for women with previous GDM. Methods: We searched for RCTs involving women with previous GDM that compared lifestyle interventions—diet, physical activity or breastfeeding—at postpartum with usual care up to May 2018. Results: Of 1,895 abstracts identified, we selected 15 studies investigating incidence of diabetes or changes in glycemia. Most interventions focused on changes in diet and physical activity, only one also on incentive to breastfeeding. Meta-analysis of 8 studies investigating incidence of diabetes revealed a homogeneous (I2 = 10%), reduction of 25% (RR = 0.75; 95%CI: 0.55–1.03) borderline statistically significant. Only trials offering intervention soon after delivery (<6 months post-partum) were effective (RR = 0.61; 95%CI: 0.40–0.94; p for subgroup comparison = 0.11). Overall, no benefit was found regarding measures of glycemia. Although moderate reductions in weight (MD = −1.07 kg; −1.43−0.72 kg); BMI (MD = −0.94 kg/m2; −1.79 −0.09 kg/m2); and waist circumference (MD = −0.98 cm; −1.75 −0.21 cm) were observed, effects were larger with longer follow-up. Conclusions: Summary results of the available evidence support benefits of lifestyle interventions at postpartum for women with previous GDM. Benefits, although smaller than those of major trials based in older subjects receiving intensive interventions, appear clinically relevant for this young subset of woman. Further studies are needed to improve the quality of the evidence and to further tailor interventions to this specific setting.application/pdfengFrontiers in endocrinology. [Lausanne : Frontiers Research Foundation]. Vol. 9, (Oct. 2018), Article 583, [13] p.Diabetes mellitus tipo 2Diabetes gestacionalRevisão sistemáticaMulheresEstilo de vidaGestationalLife stylePrimary preventionWomenLifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysisEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001099953.pdf.txt001099953.pdf.txtExtracted Texttext/plain48078http://www.lume.ufrgs.br/bitstream/10183/199831/2/001099953.pdf.txt0b31af72705121917ebfa4488f64f54fMD52ORIGINAL001099953.pdfTexto completo (inglês)application/pdf2432773http://www.lume.ufrgs.br/bitstream/10183/199831/1/001099953.pdf1b8ead57805be9bd6c90ba96d3125e98MD5110183/1998312019-09-29 03:45:43.307361oai:www.lume.ufrgs.br:10183/199831Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2019-09-29T06:45:43Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
title |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
spellingShingle |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis Goveia, Pâmella Diabetes mellitus tipo 2 Diabetes gestacional Revisão sistemática Mulheres Estilo de vida Gestational Life style Primary prevention Women |
title_short |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
title_full |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
title_fullStr |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
title_full_unstemmed |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
title_sort |
Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus : a systematic review and meta-analysis |
author |
Goveia, Pâmella |
author_facet |
Goveia, Pâmella Cañon-Montañez, Wilson Santos, Danilo de Paula Lopes, Gabriela Wünsch Ma, Ronald Ching Wan Duncan, Bruce Bartholow Ziegelmann, Patricia Klarmann Schmidt, Maria Inês |
author_role |
author |
author2 |
Cañon-Montañez, Wilson Santos, Danilo de Paula Lopes, Gabriela Wünsch Ma, Ronald Ching Wan Duncan, Bruce Bartholow Ziegelmann, Patricia Klarmann Schmidt, Maria Inês |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Goveia, Pâmella Cañon-Montañez, Wilson Santos, Danilo de Paula Lopes, Gabriela Wünsch Ma, Ronald Ching Wan Duncan, Bruce Bartholow Ziegelmann, Patricia Klarmann Schmidt, Maria Inês |
dc.subject.por.fl_str_mv |
Diabetes mellitus tipo 2 Diabetes gestacional Revisão sistemática Mulheres Estilo de vida |
topic |
Diabetes mellitus tipo 2 Diabetes gestacional Revisão sistemática Mulheres Estilo de vida Gestational Life style Primary prevention Women |
dc.subject.eng.fl_str_mv |
Gestational Life style Primary prevention Women |
description |
Background: Type 2 diabetes is increasing among the young, and gestational diabetes (GDM) offers a unique opportunity for diabetes prevention. We aimed to systematically review postpartum randomized trials to summarize the benefits of lifestyle interventions for women with previous GDM. Methods: We searched for RCTs involving women with previous GDM that compared lifestyle interventions—diet, physical activity or breastfeeding—at postpartum with usual care up to May 2018. Results: Of 1,895 abstracts identified, we selected 15 studies investigating incidence of diabetes or changes in glycemia. Most interventions focused on changes in diet and physical activity, only one also on incentive to breastfeeding. Meta-analysis of 8 studies investigating incidence of diabetes revealed a homogeneous (I2 = 10%), reduction of 25% (RR = 0.75; 95%CI: 0.55–1.03) borderline statistically significant. Only trials offering intervention soon after delivery (<6 months post-partum) were effective (RR = 0.61; 95%CI: 0.40–0.94; p for subgroup comparison = 0.11). Overall, no benefit was found regarding measures of glycemia. Although moderate reductions in weight (MD = −1.07 kg; −1.43−0.72 kg); BMI (MD = −0.94 kg/m2; −1.79 −0.09 kg/m2); and waist circumference (MD = −0.98 cm; −1.75 −0.21 cm) were observed, effects were larger with longer follow-up. Conclusions: Summary results of the available evidence support benefits of lifestyle interventions at postpartum for women with previous GDM. Benefits, although smaller than those of major trials based in older subjects receiving intensive interventions, appear clinically relevant for this young subset of woman. Further studies are needed to improve the quality of the evidence and to further tailor interventions to this specific setting. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
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2019-09-28T03:47:41Z |
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Estrangeiro info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/199831 |
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1664-2392 |
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001099953 |
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http://hdl.handle.net/10183/199831 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Frontiers in endocrinology. [Lausanne : Frontiers Research Foundation]. Vol. 9, (Oct. 2018), Article 583, [13] p. |
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