Postpartum life interventions to prevent type 2 diabetes in women with gestational diabetes: A systematic review and meta-analysis

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-05-10 DOI:10.1111/jdi.14220

Yu Wang, Wenjun Wei, Heming Guo, Dengmin Wang, Xueli Wei, Chunlan Zhang, Xiaoyan Zhang, Yun Huang

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引用次数: 0

Abstract

Aims/Introduction

Type 2 diabetes mellitus is a major metabolic disease that seriously endangers life and health, but women with gestational diabetes mellitus are at increased risk for developing type 2 diabetes mellitus. This study aimed to evaluate the effectiveness of postpartum lifestyle intervention on the prevention of type 2 diabetes mellitus, and the effect of lifestyle intervention on glycemic outcomes and anthropometric measures.

Materials and Methods

We searched PubMed and other databases to retrieve articles published before May 21, 2023, on randomized controlled trials of postnatal lifestyle interventions (diet and/or physical activity) in women with gestational diabetes mellitus. We estimated the pooled odds ratios using fixed or random effects models and conducted a subgroup analysis of the different intervention methods to explore differences in the different lifestyle interventions.

Results

The review included 17 randomized controlled trials. Overall, lifestyle changes started after a pregnancy complicated by gestational diabetes mellitus an 11% (RR = 0.89; 95% CI: 0.74–1.07) reduction in diabetes risk; significant differences were found for weight (MD = −1.33; 95% CI: [−1.76; −0.89], P < 0.00001) body mass index (MD = −0.53; 95% CI: [−0.74, −0.32], P < 0.00001), and waist circumference change (MD = −1.38; 95% CI: [−2.12; −0.64], P = 0.0002) but not for fasting glucose (MD = −0.06; 95% CI: [−0.19; 0.06], P = 0.32), 2 h glucose (MD = −0.12; 95% CI: [−0.30; 0.06], P = 0.19), and hemoglobin A1c (MD = −0.11; 95% CI: [−0.23; 0.02], P = 0.09). Subgroup analyses showed no significant differences in the effects of different lifestyle interventions on the incidence of type 2 diabetes, blood glucose levels, and anthropometric parameters.

Conclusion

Our comprehensive meta-analysis of lifestyle interventions can improve modifiable anthropometric measures in women with gestational diabetes. We need further research to provide more intensive lifestyle intervention, more scientific intervention methods, and to reduce the incidence of type 2 diabetes in patients with gestational diabetes.

Abstract Image

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预防妊娠糖尿病妇女 2 型糖尿病的产后生活干预：系统回顾和荟萃分析。

目的/引言2型糖尿病是一种严重危害生命和健康的重大代谢性疾病，但患有妊娠糖尿病的妇女患2型糖尿病的风险增加。本研究旨在评估产后生活方式干预对预防2型糖尿病的效果，以及生活方式干预对血糖结果和人体测量指标的影响：我们检索了PubMed和其他数据库，检索了2023年5月21日之前发表的关于妊娠糖尿病妇女产后生活方式干预（饮食和/或体育锻炼）随机对照试验的文章。我们使用固定或随机效应模型估算了汇总的几率比，并对不同的干预方法进行了亚组分析，以探讨不同生活方式干预的差异：综述包括 17 项随机对照试验。总体而言，在妊娠并发妊娠糖尿病后开始改变生活方式可使糖尿病风险降低 11% (RR = 0.89; 95% CI: 0.74-1.07)；体重方面存在显著差异 (MD = -1.33; 95% CI: [-1.76; -0.89], P 结论：我们对生活方式干预的综合荟萃分析可以改善妊娠糖尿病妇女的可调节人体测量指标。我们需要进一步的研究，以提供更深入的生活方式干预、更科学的干预方法，并降低妊娠糖尿病患者的 2 型糖尿病发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).