Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot

D. Simmons, J.G.M. Jelsma, S. Galjaard, R. Devlieger, A. van Assche, G. Jans, R. Corcoy, J.M. Adelantado, F. Dunne, G. Desoye, J. Harreiter, A. Kautzky-Willer, P. Damm, E.R. Mathiesen, D.M. Jensen, L.L. Andersen, A. Lapolla, M. Dalfra, A. Bertolotto, E. Wender-OzegowskaA. Zawiejska, D. Hill, P. Rebollo, F.J. Snoek, M.N.M. van Poppel

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Abstract

Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35-37 weeks. Among the 150 trial participants, 32% developed GDM by 35-37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (-2.6 kg [95% CI -4.9, -0.2]; P = 0.03) and lower fasting glucose (-0.3 mmol/L [-0.4, -0.1]; P = 0.01) than those in the PA group at 24-28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed. An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women
Original languageEnglish
Pages (from-to)1650-1656
JournalDiabetes Care
Volume38
Issue number9
DOIs
Publication statusPublished - 2015

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