Brokaw Sarah M, Carpenedo Dorota, Campbell Paul, Butcher Marcene K, Helgerson Steven D, Harwell Todd S
Montana Department of Public Health and Human Services, Cogswell Building, C-301, P.O. Box 202951, Helena, MT, 59620-2951, USA.
Matern Child Health J. 2018 Apr;22(4):529-537. doi: 10.1007/s10995-017-2420-y.
Objectives To evaluate lifestyle change outcomes among women with and without a history of gestational diabetes mellitus (GDM) enrolled in the Montana Diabetes Prevention Program (DPP). Methods Participation, self-monitoring behavior, weight loss, and cardiometabolic risk reduction were compared among 5091 women at high-risk for type 2 diabetes, with and without a history of GDM, enrolled in the Montana DPP between 2008 and 2015. Results Women with a history of GDM (6% of enrolled women, n = 283) were significantly younger than women without GDM. No significant differences in participation, self-monitoring fat intake, achievement of the physical activity goal, or weight loss were found among women with and without a history of GDM. Overall, women lost an average of 5.0 kg (± 6.5), and 45 and 29% of women achieved 5 and 7% weight loss, respectively. Both groups lost significant and comparable amounts of weight. After adjusting for age and other factors, no differences were found in achievement of ≥ 5% weight loss (AOR 0.84; 95% CI 0.61-1.16) or the ≥ 7% weight loss goal (AOR 1.04; 95% CI 0.73-1.47) among women with and without a history of GDM. Conclusions for Practice Our findings suggest that women with and without a history of GDM successfully participate in and achieve significant weight loss in the DPP. Health care providers should identify and refer women with risk factors for type 2 diabetes, including a history of GDM, to a DPP within their community.
目的 评估参加蒙大拿糖尿病预防项目（DPP）的有和没有妊娠期糖尿病（GDM）病史的女性的生活方式改变结果。方法 比较了2008年至2015年间参加蒙大拿DPP的5091名2型糖尿病高危女性，她们中有和没有GDM病史。结果 有GDM病史的女性（占登记女性的6%，n = 283）比没有GDM病史的女性明显年轻。在有和没有GDM病史的女性中，参与度、自我监测脂肪摄入量、达到身体活动目标或体重减轻方面没有显著差异。总体而言，女性平均减重5.0 kg（±6.5），45%和29%的女性分别实现了5%和7%的体重减轻。两组减重的幅度都很大且相当。在调整年龄和其他因素后，有和没有GDM病史的女性在实现≥5%体重减轻（调整后比值比[AOR] 0.84；95%置信区间[CI] 0.61 - 1.16）或≥7%体重减轻目标（AOR 1.04；95% CI 0.73 - 1.47）方面没有差异。实践结论 我们的研究结果表明，有和没有GDM病史的女性都能成功参与蒙大拿DPP并实现显著减重。医疗保健提供者应识别并将有2型糖尿病风险因素（包括有GDM病史）的女性转介到其所在社区的DPP项目。
