Kragelund Nielsen Karoline, Dahl-Petersen Inger Katrine, Jensen Dorte Møller, Damm Peter, Ovesen Per, Mathiesen Elisabeth R, Kampmann Ulla, Vinter Christina Anne, Knorr Sine, Andersen Lise Lotte, Davidsen Emma, Jensen Nanna Husted, Aalders Jori, Thøgersen Maja, Timm Anne, Støvring Henrik, Maindal Helle Terkildsen
Department of Prevention, Health Promotion & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark.
Steno Diabetes Center Odense, 5000 Odense, Denmark.
J Clin Endocrinol Metab. 2025 Jul 15;110(8):e2456-e2470. doi: 10.1210/clinem/dgae856.
Gestational diabetes mellitus (GDM) increases the risk of future type 2 diabetes (T2DM), but effective and feasible interventions to reduce this risk are lacking.
To evaluate the effectiveness of a family-based health promotion intervention on T2DM risk factors and quality of life among women with recent GDM.
Multicenter, parallel, open-label randomized controlled trial with 2:1 allocation ratio.
Three sites in Denmark.
Women diagnosed with GDM.
INTERVENTION(S): The intervention consisted of (1) home visits with tailored family-based counseling (2) digital health coaching, and (3) structured cross-sectoral communication.
Primary outcomes were body mass index (BMI) and quality of life [12-Item Short-Form mental component score (SF12 MCS)] 1 year after delivery.
We randomized 277 women to the intervention (n = 184) or usual care group (n = 93). The intervention did not result in significantly lower BMI [-0.44 kg/m2; 95% confidence interval (CI) -0.98 to 0.11] or higher SF12 MCS (0.06; 95% CI -2.15 to 2.27) compared to the usual care group. A prespecified post hoc analysis demonstrated a reduced BMI in the intervention group among women with BMI ≥25 kg/m2 (-0.86 kg/m2; 95% CI -1.58 to -0.14).Analyses of secondary and tertiary outcomes indicated significantly lower 2-hour insulin (-94.3 pmmol/L; 95% CI -167.9 to -20.6) and triglycerides (-0.18 mmol/L; 95% CI -0.30 to -0.05) levels, and odds of fasting plasma glucose ≥6·1 mmol/L (odds ratio 0.33; 95% CI 0.12 to 0.91) in the intervention group.
The intervention did not result in lower BMI or increased quality of life but seemingly reduced other risk factors and lowered BMI in the subgroup of overweight women.
妊娠期糖尿病（GDM）会增加未来患2型糖尿病（T2DM）的风险，但缺乏有效且可行的干预措施来降低这种风险。
评估基于家庭的健康促进干预对近期患有GDM的女性的T2DM危险因素和生活质量的有效性。
多中心、平行、开放标签随机对照试验，分配比例为2:1。
丹麦的三个地点。
被诊断为GDM的女性。
干预包括（1）进行有针对性的基于家庭的咨询的家访，（2）数字健康指导，以及（3）结构化跨部门沟通。
主要结局为产后1年的体重指数（BMI）和生活质量[12项简短形式心理成分得分（SF12 MCS）]。
我们将277名女性随机分为干预组（n = 184）或常规护理组（n = 93）。与常规护理组相比，干预并未导致BMI显著降低[-0.44 kg/m2；95%置信区间（CI）-0.98至0.11]或SF12 MCS显著升高（0.06；95% CI -2.15至2.27）。一项预先指定的事后分析显示，在BMI≥25 kg/m2的女性中，干预组的BMI有所降低（-0.86 kg/m2；95% CI -1.58至-0.14）。对次要和三级结局的分析表明，干预组的2小时胰岛素水平（-94.3 pmmol/L；95% CI -167.9至-20.6）和甘油三酯水平（-0.18 mmol/L；95% CI -0.30至-0.05）显著降低，空腹血糖≥6·1 mmol/L的几率也降低（优势比0.33；95% CI 0.12至0.91）。
该干预并未降低BMI或提高生活质量，但似乎降低了其他危险因素，并降低了超重女性亚组的BMI。
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