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Effects of lifestyle intervention on long‐term risk of diabetes in women with prior gestational diabetes: A systematic review and meta‐analysis of randomized controlled trials
Author(s) -
Li Ninghua,
Yang Yingzi,
Cui Dingyu,
Li Changping,
Ma Ronald C.W.,
Li Jing,
Yang Xilin
Publication year - 2021
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.13122
Subject(s) - medicine , gestational diabetes , randomized controlled trial , pregnancy , diabetes mellitus , relative risk , type 2 diabetes , obstetrics , meta analysis , confidence interval , physical therapy , gestation , endocrinology , genetics , biology
Summary We performed two meta‐analyses to estimate the effects of lifestyle intervention during pregnancy and after delivery on the risk of postpartum diabetes among women with gestational diabetes mellitus (GDM). We searched the major databases to retrieve articles published in English or Chinese before 15 December 2019. The inclusion criteria were randomized controlled trials (RCTs) of diet, physical activity or both, conducted during or after pregnancy among women with GDM. The exclusion criteria were (1) having type 1 or type 2 diabetes before the intervention and (2) without postpartum diabetes documented. Fixed‐effects model analysis was used to obtain the pooled relative risks (RRs) and 95% confidence intervals (CIs) of lifestyle intervention for diabetes in women with GDM. Four RCTs were identified to have implemented the intervention during pregnancy ( n = 2883) and 10 to have conducted it within 3 years after delivery ( n = 1733). Lifestyle intervention during pregnancy was not effective at reducing the risk of postpartum diabetes (RR: 0.91, 95%CI: 0.66–1.25). However, lifestyle intervention initiated within 3 years after delivery was highly effective in reducing the risk of postpartum diabetes (pooled RR: 0.57, 95% CI: 0.42–0.78). In conclusion, our findings support the early initiation of lifestyle intervention in women with GDM for the prevention of diabetes.