{"title":"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。","authors":"Yu Wang, Wenjun Wei, Heming Guo, Dengmin Wang, Xueli Wei, Chunlan Zhang, Xiaoyan Zhang, Yun Huang","doi":"10.1111/jdi.14220","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims/Introduction</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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], <i>P</i> < 0.00001) body mass index (MD = −0.53; 95% CI: [−0.74, −0.32], <i>P</i> < 0.00001), and waist circumference change (MD = −1.38; 95% CI: [−2.12; −0.64], <i>P</i> = 0.0002) but not for fasting glucose (MD = −0.06; 95% CI: [−0.19; 0.06], <i>P</i> = 0.32), 2 h glucose (MD = −0.12; 95% CI: [−0.30; 0.06], <i>P</i> = 0.19), and hemoglobin A1c (MD = −0.11; 95% CI: [−0.23; 0.02], <i>P</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"15 8","pages":"1115-1128"},"PeriodicalIF":3.1000,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292388/pdf/","citationCount":"0","resultStr":"{\"title\":\"Postpartum life interventions to prevent type 2 diabetes in women with gestational diabetes: A systematic review and meta-analysis\",\"authors\":\"Yu Wang, Wenjun Wei, Heming Guo, Dengmin Wang, Xueli Wei, Chunlan Zhang, Xiaoyan Zhang, Yun Huang\",\"doi\":\"10.1111/jdi.14220\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims/Introduction</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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], <i>P</i> < 0.00001) body mass index (MD = −0.53; 95% CI: [−0.74, −0.32], <i>P</i> < 0.00001), and waist circumference change (MD = −1.38; 95% CI: [−2.12; −0.64], <i>P</i> = 0.0002) but not for fasting glucose (MD = −0.06; 95% CI: [−0.19; 0.06], <i>P</i> = 0.32), 2 h glucose (MD = −0.12; 95% CI: [−0.30; 0.06], <i>P</i> = 0.19), and hemoglobin A1c (MD = −0.11; 95% CI: [−0.23; 0.02], <i>P</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":51250,\"journal\":{\"name\":\"Journal of Diabetes Investigation\",\"volume\":\"15 8\",\"pages\":\"1115-1128\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292388/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14220\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes Investigation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14220","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Postpartum life interventions to prevent type 2 diabetes in women with gestational diabetes: A systematic review and meta-analysis
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.
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).
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