Department of Health & Wellness Design, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA.
Applied Health Sciences, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA.
Curr Diab Rep. 2024 Apr;24(4):74-83. doi: 10.1007/s11892-024-01535-5. Epub 2024 Feb 17.
The purpose of this study was to conduct a scoping review to map intervention, sample, and physiologic measurement characteristics of lifestyle interventions for gestational diabetes mellitus (GDM) prevention.
A total of 19 studies met selection criteria from 405 articles screened (PubMed, Web of Science). No studies were US-based (47% multi-site), and all were delivered in clinical settings. The most targeted nutrition components were low carbohydrate intake (sugar rich foods/added sugars, low glycemic index), low fat intake (mainly low-fat meat, dairy, and saturated fat), and increased fruits and vegetables. Many studies promoted 150 min/week moderate-intensity physical activity. Only two studies provided supervised physical activity sessions. Dietitians and nurses were the most common implementers. Samples were characterized as adults with obesity (mean age 31 yr, BMI 31 kg/m). Asian populations were predominantly studied. Four studies used theoretical frameworks (75% of which used Social Cognitive Theory). GDM diagnostic criteria set forth by the American Diabetes Association were the most widely used. Insulin sensitivity was commonly assessed via fasting indices. There was a lack of multi-disciplinary, multi-level, and theory-based lifestyle interventions for reducing GDM risk. Addressing these gaps and prioritizing high-risk populations in the US with measurement of traditional and novel biomarkers will advance the field.
本研究旨在进行范围综述，以绘制生活方式干预预防妊娠糖尿病（GDM）的干预、样本和生理测量特征图。
从筛选出的 405 篇文章中，共有 19 项研究符合选择标准（PubMed，Web of Science）。没有一项研究是基于美国的（47%是多地点的），而且所有研究都是在临床环境中进行的。最有针对性的营养成分是低碳水化合物摄入（含糖量高的食物/添加糖、低血糖指数）、低脂肪摄入（主要是低脂肉类、奶制品和饱和脂肪）以及增加水果和蔬菜。许多研究提倡每周进行 150 分钟中等强度的身体活动。只有两项研究提供了监督性的体育活动课程。营养师和护士是最常见的执行者。样本的特点是肥胖的成年人（平均年龄 31 岁，BMI 为 31kg/m2）。亚洲人群是主要的研究对象。四项研究使用了理论框架（其中 75%使用了社会认知理论）。美国糖尿病协会制定的 GDM 诊断标准是最广泛使用的。胰岛素敏感性通常通过空腹指数来评估。目前缺乏多学科、多层次和基于理论的生活方式干预措施来降低 GDM 的风险。解决这些差距，并优先考虑美国高风险人群，同时测量传统和新型生物标志物，将推动该领域的发展。
