Office of Research, Denver Health, Denver, Colorado; Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado.
Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Am J Prev Med. 2023 Aug;65(2):317-321. doi: 10.1016/j.amepre.2023.03.006. Epub 2023 Mar 13.
Women with previous gestational diabetes are at high risk of developing Type 2 diabetes. The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention to prevent Type 2 diabetes. Although NDPP programs are open to adults of any age, participants are usually older adults. Effectiveness among younger women with previous gestational diabetes is largely unknown.
The NDPP was delivered by lifestyle coaches in a large network of Federally Qualified Health Centers. Reach, retention, physical activity, and weight loss outcomes were compared between women aged <40 years with previous gestational diabetes and all other participants. Data were collected from 2013 to 2019 and analyzed in 2022.
Among 2,865 enrollees who agreed to start the yearlong NDPP, 63.3% were Latinx, 18.8% were non-Latinx Black, and 16.4% were non-Latinx White. Younger women with previous gestational diabetes represented <4% (n=107) of participants. There was no significant difference in the frequency of attending ≥1 NDPP session between these women and all other participants (37.4% vs 44.6%; p=0.146). However, among those attending ≥1 session (n=1,265), younger women with previous gestational diabetes attended more (11.27 ± 1.27 vs 8.50 ± 0.22 sessions, p=0.021) and had greater weight loss (3.04% ± 0.59 vs. 1.49% ± 0.11, p=0.010) in covariate-adjusted models than other participants.
Diverse younger women with previous gestational diabetes attending the NDPP had one third greater attendance and twice as much weight loss as other NDPP participants but represented a much smaller proportion of enrollees. Thus, the NDPP appears to be a beneficial but underutilized resource for this high-risk population.
曾患有妊娠糖尿病的女性患 2 型糖尿病的风险很高。国家糖尿病预防计划（NDPP）是一种广泛传播的生活方式干预措施，旨在预防 2 型糖尿病。尽管 NDPP 计划对任何年龄段的成年人开放，但参与者通常是老年人。在曾患有妊娠糖尿病的年轻女性中的有效性在很大程度上尚不清楚。
NDPP 由生活方式教练在一个大型合格的联邦卫生中心网络中提供。比较了年龄<40 岁且曾患有妊娠糖尿病的女性与所有其他参与者之间的覆盖范围、保留率、身体活动和体重减轻结果。数据收集于 2013 年至 2019 年，并于 2022 年进行分析。
在 2865 名同意开始为期一年的 NDPP 的参与者中，63.3%是拉丁裔，18.8%是非拉丁裔黑人，16.4%是非拉丁裔白人。曾患有妊娠糖尿病的年轻女性<4%（n=107）。这些女性与所有其他参与者相比，参加≥1 次 NDPP 课程的频率没有显著差异（37.4%比 44.6%；p=0.146）。然而，在参加≥1 次课程的参与者中（n=1265），曾患有妊娠糖尿病的年轻女性参加的课程更多（11.27±1.27 次比 8.50±0.22 次，p=0.021），体重减轻更多（3.04%±0.59%比 1.49%±0.11%，p=0.010），在调整协变量的模型中。
参加 NDPP 的不同年轻的曾患有妊娠糖尿病的女性的出勤率增加了三分之一，体重减轻了两倍，但她们在参与者中所占比例要小得多。因此，NDPP 似乎是高危人群的有益但未充分利用的资源。
