Centre for Public Health, Queen's University, Belfast, United Kingdom.
Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, United Kingdom.
J Clin Endocrinol Metab. 2018 Jul 1;103(7):2478-2487. doi: 10.1210/jc.2017-02654.
Gestational diabetes mellitus (GDM) is associated with a sevenfold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity.
To determine the impact of a postnatal lifestyle intervention program for overweight women with previous gestational diabetes mellitus (PAIGE).
Postnatal overweight women with previous GDM participated in a multicenter randomized controlled trial between June 2013 and December 2014. The intervention comprised a 1-hour educational program, a free 3-month referral to a commercial weight management organization (Slimming World), a pedometer, and structured telephone and text support, in addition to usual care. The control group received usual care only. The primary outcome was weight loss at 6 months.
Sixty women were randomized (29 intervention; 31 control) in two centers based on their week of attendance. The intervention group demonstrated significant weight loss at 6 months after randomization compared with the control group: mean ±SD, 3.9 ± 7.0 kg vs 0.7 ±3.8 kg (P = 0.02). Blood glucose levels did not significantly differ. With respect to well-being measures, a bodily pain was significantly reduced in the intervention group (P = 0.007).
PAIGE resulted in significantly greater weight loss at 6 months compared with usual care. Such weight loss could prove beneficial in terms of better long-term health and subsequent prevention of type 2 diabetes in overweight women with previous GDM. Future interventions must consider recruitment strategies, timing of the intervention, and inclusion of partners and/or other family members.
妊娠糖尿病（GDM）会使患者终生患 2 型糖尿病的风险增加 7 倍。怀孕期间体重过度增加和产后体重滞留是长期肥胖的既定预测因素。
确定针对超重且有既往妊娠糖尿病（PAIGE）的女性的产后生活方式干预计划的影响。
2013 年 6 月至 2014 年 12 月，在多中心随机对照试验中招募了患有超重且有既往 GDM 的产后女性。干预措施包括 1 小时的教育计划、免费 3 个月的商业体重管理组织（Slimming World）转诊、计步器以及结构化的电话和短信支持，此外还有常规护理。对照组仅接受常规护理。主要结局为 6 个月时的体重减轻。
根据就诊周数，在两个中心随机分配了 60 名女性（29 名干预组；31 名对照组）。与对照组相比，干预组在随机分组后 6 个月时体重明显减轻：平均±SD，3.9±7.0kg 比 0.7±3.8kg（P=0.02）。血糖水平无显著差异。关于幸福感衡量标准，干预组的身体疼痛明显减轻（P=0.007）。
PAIGE 导致 6 个月时体重明显减轻，优于常规护理。这种体重减轻可能对超重且有既往 GDM 的女性的长期健康和随后预防 2 型糖尿病有益。未来的干预措施必须考虑招募策略、干预时间以及包括伴侣和/或其他家庭成员。
