Gestational diabetes mellitus is associated with increased risk of adverse perinatal outcomes. Despite this relationship, ways to prevent gestational diabetes mellitus remain unproven. A recent multicenter pilot study, which was co-authored by Judith Jelsma and Mireille van Poppel from our group, compared the impact of three lifestyle interventions on gestational diabetes mellitus risk; healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA].
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 gestational diabetes mellitus were randomised to a HE, PA, or HE+PA intervention. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were gestational weight gain, fasting glucose, and insulin sensitivity at 35–37 weeks.
It was concluded that an HE intervention among obese European women led to lower gestational weight gain, fasting glucose, and 2-h insulin concentrations by 35–37 weeks gestation, as compared to a PA intervention or a combination of the two. Although a larger trial is still clearly needed, these pilot findings are promising and support the use of early healthy eating interventions in obese pregnant women.
Simmons D, Jelsma J, Galjaard S, et al. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus (GDM): The DALI Lifestyle Pilot. Diabetes Care June 25, 201. ePub ahead of print doi:10.2337/dc15-0360