Improving the effectiveness of lifestyle interventions for gestational diabetes prevention: a meta‐analysis and meta‐regression

Xy, Guo; J, Shu; Xh, Fu; Chen, Xiaopan; Zhang, L; Mx, Ji; Xm, Liu; Yu, Tao; Sheng, Jian‐Zhong; Huang, Hailong

doi:10.1111/1471-0528.15467

Cited by 102 publications

(117 citation statements)

References 68 publications

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“…Also, the results were in the same line with Guo et al, [21], in their Chinese study for increasing the effect of lifestyle programs about the prevention of gestational diabetes; as they revealed that practices in the form of nutrition and exercise within pregnancy were preventive of GDM (RR 0.77, 95% CI [0.69; 0.87]).…”

Section: Discussionsupporting

confidence: 85%

Educational Protocol to Improve Pregnant Women Practices about Gestational Diabetes Mellitus

Hagrass¹

2019

SJNHC

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Background: Gestational Diabetes Mellitus is considered to be a significant problem among pregnant women in Egypt. Aim: To evaluate the effect of educational protocol to improve pregnant women practices about gestational diabetes mellitus. Design: A quasi-experimental design was used. Setting: The outpatient diabetic clinic at Zagazig university hospital. Sample: A purposive sample of eighty pregnant diabetic women. Tools: Two tools were used in the study, Tool (1): Contained two parts; (1) demographic characteristics, (2) History about reproductive profile during pregnancy, Tool (2): Included two parts, assessment of knowledge of pregnant women about DM, and assessment of practice of pregnant women about DM. Results: The mean age of the pregnant women were 32.04 ± 9.36 years, also it was revealed that the total knowledge scores improved from 31.35% to 58.20%, with a highly significant difference (p=0.0044) for the participants, additionally, the overall increase in adequate practices improved from 56 to 78.5% after the implementation of the protocol sessions, with a significant difference (p=0.0106). Conclusion: The implementation of educational protocol for pregnant women was effective and enhanced their practices, and knowledge regarding the gestational diabetes mellitus. Recommendation: The study recommended that further studies for pregnant women with gestational diabetes mellitus should be applied in all health care centers.

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Section: Discussionsupporting

confidence: 85%

Educational Protocol to Improve Pregnant Women Practices about Gestational Diabetes Mellitus

Hagrass¹

2019

SJNHC

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“…Instead, interventions were most effective in populations with high incidence of GDM rather than simply in women who are overweight or obese. Furthermore, moderate intensity exercise for 50-60 min twice a week could lead to an approximately 24% reduction in GDM [12].…”

Section: Lifestyle Interventions To Prevent Gdmmentioning

confidence: 99%

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

2020

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Gestational diabetes (GDM) has deleterious effects on the offspring. Maternal obesity and excessive gestational weight gain (GWG), often associated with diabetes, also contribute to these adverse outcomes. Objectives: To assess the benefit for the offspring of maternal lifestyle interventions, including diets and physical activity, to prevent or to improve GDM and to limit excessive GWG. Method: Systematic review of meta-analyses published in English between December 2014 and November 2019. Results: Lifestyle interventions to reduce the risk of GDM reported a decreased risk of 15% to 40%, with a greater effect of exercise compared to diet. Combined lifestyle interventions specifically designed to limit GWG reduced GWG by 1.6 kg in overweight and obese women, and on average by 0.7 to 1 kg in all pregnant women. In these trials, adverse neonatal outcomes were poorly studied. Combined lifestyle interventions in women with GDM significantly reduced fetal growth. Altogether, lifestyle interventions reduced the risk of preterm birth and shoulder dystocia, but individually, diets or exercise alone had no effect on neonatal adverse outcomes. Conclusion: Specific maternal, neonatal and offspring benefits of lifestyle interventions during pregnancy to prevent or improve GDM control or to limit GWG still require clarification.

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“…Notwithstanding, recent reports showed that despite the extensive intervention of the Diabetes Prevention Program and Diabetes Prevention Study, almost 15% of women still had GDM 12 . Improving the lifestyle before pregnancy and postpartum gives insignificantly better results compare to dietary intervention 13 . The main issue of lifestyle improvement and diet management focuses on the firsttrimester time-points when methods for diagnosis of GDM and DF are still insensitive.…”

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confidence: 99%

Molecular pathophysiology of diabetes mellitus during pregnancy with antenatal complications

Kopylov

Папышева

Gribova³

et al. 2020

Sci Rep

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Gestational diabetes mellitus is a daunting problem accompanied by severe fetal development complications and type 2 diabetes mellitus in postpartum. Diagnosis of diabetic conditions occurs only in the second trimester, while associated antenatal complications are typically revealed even later. We acquired an assay of peripheral and cord blood samples of patients with different types of diabetes mellitus who delivered either healthy newborns or associated with fetopathy complications. Obtained data were handled with qualitative and quantitative analysis. Pathways of molecular events involved in diabetes mellitus and fetopathy were reconstructed based on the discovered markers and their quantitative alteration. Plenty of pathways were integrated to differentiate the type of diabetes and to recognize the impact of the diabetic condition on fetal development. The impaired triglycerides transport, glucose uptake, and consequent insulin resistance are mostly affected by faulted lipid metabolism (APOM, APOD, APOH, APOC1) and encouraged by oxidative stress (CP, TF, ORM2) and inflammation (CFH, CFB, CLU) as a secondary response accompanied by changes in matrix architecture (AFM, FBLN1, AMBP). Alterations in proteomes of peripheral and cord blood were expectedly unequal. Both up- and downregulated markers were accommodated in the cast of molecular events interconnected with the lipid metabolism, RXR/PPAR-signaling pathway, and extracellular architecture modulation. The obtained results congregate numerous biological processes to molecular events that underline diabetes during gestation and uncover some critical aspects affecting fetal growth and development.

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Improving the effectiveness of lifestyle interventions for gestational diabetes prevention: a meta‐analysis and meta‐regression

Abstract: Four key effectiveness moderators of lifestyle interventions for GDM prevention.

Cited by 102 publications

References 68 publications

Educational Protocol to Improve Pregnant Women Practices about Gestational Diabetes Mellitus

Educational Protocol to Improve Pregnant Women Practices about Gestational Diabetes Mellitus

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

Molecular pathophysiology of diabetes mellitus during pregnancy with antenatal complications

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