Department of Medicine, University of Michigan, Ann Arbor, USA.
Diabet Med. 2012 Feb;29(2):278-83. doi: 10.1111/j.1464-5491.2011.03415.x.
Women with remote histories of gestational diabetes mellitus can reduce their diabetes risk through lifestyle changes, but the effectiveness of interventions in women with more recent histories of gestational diabetes has not been reported. Therefore, we conducted a pilot study of a low-intensity web-based pedometer programme targeting glucose intolerance among women with recent gestational diabetes.
Women with a gestational diabetes delivery within the past 3 years were randomized to a 13-week intervention consisting of a structured web-based pedometer programme which gave personalized steps-per-week goals, pedometers and education regarding lifestyle modification, or to a letter about diabetes risk reduction and screening after delivery for gestational diabetes (control condition). The main outcome measures were change in fasting plasma glucose and 2-h glucose levels on a 75-g oral glucose tolerance test between baseline and 13-week follow-up. Weight was a secondary outcome and behavioural constructs (self-efficacy, social support, risk perception) were also assessed.
Forty-nine women were enrolled. At 13-week follow-up, women randomized to the intervention did not have significant changes in behavioural constructs, physical activity or anthropometrics compared with women in the control group. Changes in fasting plasma glucose (-0.046 mmol/l vs. 0.038 mmol/l, P = 0.65), 2-h glucose values (-0.48 mmol/l vs. -0.42 mmol/l, P = 0.91) and weight (-0.14 kg vs. -1.5 kg, P = 0.13) were similar between the control and intervention groups, respectively.
Structured web-based education utilizing pedometers is feasible although uptake may be low. Such programmes may need to be supplemented with additional measures in order to be effective for reduction of diabetes risk.
有远程妊娠糖尿病史的女性可以通过生活方式的改变来降低糖尿病风险，但最近有妊娠糖尿病史的女性干预的效果尚未报道。因此，我们对最近有妊娠糖尿病史的女性进行了一项基于网络的低强度计步器计划以针对葡萄糖耐量异常的试点研究。
将过去 3 年内分娩妊娠糖尿病的女性随机分配到为期 13 周的干预组，干预组包括一个结构化的基于网络的计步器计划，该计划为患者提供个性化的每周步数目标、计步器和有关生活方式改变的教育，或在产后为患者提供关于糖尿病风险降低和妊娠糖尿病筛查的一封信（对照组）。主要观察指标是在基线和 13 周随访之间空腹血浆葡萄糖和 75g 口服葡萄糖耐量试验时的 2 小时葡萄糖水平的变化。体重是次要观察指标，同时评估行为结构（自我效能感、社会支持、风险感知）。
共纳入 49 名女性。在 13 周的随访中，与对照组相比，干预组的女性在行为结构、身体活动或人体测量学方面没有明显变化。空腹血糖（-0.046mmol/L 比 0.038mmol/L，P=0.65）、2 小时血糖值（-0.48mmol/L 比-0.42mmol/L，P=0.91）和体重（-0.14kg 比-1.5kg，P=0.13）的变化在对照组和干预组之间相似。
使用计步器进行结构化的基于网络的教育是可行的，尽管参与度可能较低。为了降低糖尿病风险，此类计划可能需要辅以其他措施。
