Open AccessDiabetes prevention interventions for women after gestational diabetes mellitus: an overview of reviews
Author(s) -
Hedeager Momsen AnneMette,
Høtoft Diana,
Ørtenblad Lisbeth,
Friis Lauszus Finn,
Krogh Rubab Hassan Agha,
Lynggaard Vibeke,
Juel Christiansen Jens,
Terkildsen Maindal Helle,
Vinther Nielsen Claus
Publication year - 2021
Publication title -
endocrinology, diabetes and metabolism
Language(s) - English
Resource type - Journals
ISSN - 2398-9238
DOI - 10.1002/edm2.230
Subject(s) - medicine , psychological intervention , breastfeeding , gestational diabetes , dieticians , diabetes mellitus , type 2 diabetes , family medicine , incidence (geometry) , intervention (counseling) , gerontology , pregnancy , nursing , pediatrics , endocrinology , gestation , physics , biology , optics , genetics
Aims To present an overview of reviews of interventions for the prevention of diabetes in women after gestational diabetes mellitus (GDM) with the overall aim of gaining information in order to establish local interventions. Methods Six databases were searched for quantitative, qualitative or mixed‐methods systematic reviews. All types of interventions or screening programmes were eligible. The outcomes were effectiveness of reducing diabetes incidence, encouraging healthy behavioural changes and enhancing women's perceptions of their increased risks of developing type 2 diabetes following GDM. Results Eighteen reviews were included: three on screening programmes and seven on participation and risk perceptions. Interventions promoting physical activity, healthy diet, breastfeeding and antidiabetic medicine reported significantly decreased incidence of postpartum diabetes, up to 34% reduction after any breastfeeding compared to none. Effects were larger if the intervention began early after birth and lasted longer. Participation in screening rose up to 40% with face‐to‐face recruitment in a GDM healthcare setting. Interventions were mainly based in healthcare settings and involved up to nine health professions, councillors and peer educators, mostly dieticians. Women reported a lack of postpartum care and demonstrated a low knowledge of risk factors for developing type 2 diabetes. Typical barriers to participation were lack of awareness of increased risk and low levels of support from family. Conclusions Lifestyle interventions or pharmacological treatment postpartum was effective in decreasing diabetes incidence following GDM. Women's knowledge of the risk of diabetes and importance of physical activity was insufficient. Early face‐to‐face recruitment increased participation in screening. Programmes aimed at women following a diagnosis of GDM ought to provide professional and social support, promote screening, breastfeeding, knowledge of risk factors, be long‐lasting and offered early after birth, preferably by face‐to‐face recruitment.