Lifestyle and glycemic health 5 years postpartum in obese and non-obese high diabetes risk women

Huvinen, Emilia; Engberg, Elina; Meinilä, Jelena; Tammelin, Tuija; Kulmala, Janne; Heinonen, Kati; Bergman, Paula; Stach‐Lempinen, Beata; Koivusalo, Saila B.

doi:10.1007/s00592-020-01553-1

Cited by 5 publications

(7 citation statements)

References 44 publications

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“…Also MC4R has shown an interaction with lifestyle intervention on changes in fasting insulin and HOMA-IR 1–3 years postpartum: again, individuals with the risk allele responded to a lifestyle intervention with improvements in insulin resistance 39. In the RADIEL study, 5 years postpartum lifestyle was associated with better glycemic health only among women with prepregnancy obesity 20. In this current study, however, there were no differences in clinical characteristics, for example, BMI, between genetic risk groups suggesting that this gene-lifestyle interaction might not explain our prior findings.…”

Section: Discussionmentioning

confidence: 99%

“…Lifestyle may have individual effects on people 15 16 20. In a large cohort study, all participants benefitted from achieving lifestyle goals, for example, by improving glycemic health, but the participants at higher genetic risk benefitted the most 37.…”

Section: Discussionmentioning

confidence: 99%

“…Whether there are differences in the response to lifestyle in later years after delivery remains still unknown. At the RADIEL 5-year follow-up, diet and PA were associated with glycemic health among women with obesity but not among women with normal weight and prior GDM 20. To our knowledge, none of the prior postpartum intervention studies have investigated, if genetic background modifies the effects of lifestyle interventions in long term 13.…”

Section: Introductionmentioning

confidence: 94%

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Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

Tieu,

Koivusalo,

Lahti

et al. 2024

BMJ Open Diab Res Care

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IntroductionLifestyle interventions are effective in preventing type 2 diabetes, but genetic background may influence the individual response. In the Finnish gestational diabetes prevention study, RADIEL, lifestyle intervention during pregnancy and first postpartum year was effective in preventing gestational diabetes (GDM) and postpartum glycemic abnormalities only among women at highest genetic risk of type 2 diabetes. This study aimed to assess whether still 5 years postpartum the genetic risk modifies the association between lifestyle and glycemic health.Research design and methodsThe RADIEL study (randomized controlled trial) aimed to prevent GDM with a lifestyle intervention among high-risk women (body mass index ≥30 kg/m2and/or prior GDM). The follow-up study 5 years postpartum included anthropometric measurements, laboratory assessments, device-measured physical activity (PA), and questionnaires. A Healthy Lifestyle Score (HLS) indicated adherence to lifestyle goals (PA, diet, smoking) and a polygenic risk score (PRS) based on 50 type 2 diabetes risk alleles depicted the genetic risk.ResultsAltogether 314 women provided genetic and glycemic data 5 years postpartum. The PRS for type 2 diabetes was not associated with glycemic abnormalities, nor was HLS in the total study sample. There was, however, an interaction between HLS and type 2 diabetes PRS on glycemic abnormalities (p=0.03). When assessing the association between HLS and glycemic abnormalities in PRS tertiles, HLS was associated with reduced risk of glycemic abnormalities only among women at the highest genetic risk (p=0.008).ConclusionsThese results extend our previous findings from pregnancy and first postpartum year demonstrating that still at 5 years postpartum, healthy lifestyle is associated with a lower risk of prediabetes/diabetes only among women at the highest genetic risk of type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

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Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

Tieu,

Koivusalo,

Lahti

et al. 2024

BMJ Open Diab Res Care

Self Cite

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“…Regular exercise is known to improve blood glucose control [ 30 ] and could therefore be an important focus point for intervention strategies. In women with obesity, a higher level of physical activity has been shown to associate with better glycemic control five years postpartum [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Living with Overweight, Rather than a History of Gestational Diabetes, Influences Dietary Quality and Physical Activity during Pregnancy

2022

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(1) Background: Clinical practice guidelines recommend dietary and physical activity counselling for pregnant women with gestational diabetes (GDM). The aim of this study was to evaluate the extent to which a history of GDM and living with overweight before pregnancy modify dietary quality and physical activity during pregnancy. (2) Methods: The study is a cross-sectional study of 1034 pregnant women from different parts of Finland. The data were collected through electronic questionnaires. Dietary quality and physical activity were measured with stand-alone indices and compared according to the history of GDM and overweight status based on body mass index (BMI) category. (3) Results: Overall, 53% of the women had a poor dietary quality (Index of Diet Quality (IDQ) score <10) and 45% a light physical activity level. The IDQ score or physical activity levels did not differ between women with and without a history of GDM. Instead, in women with overweight/obesity both the IDQ score and physical activity levels were lower compared to their normal-weight counterparts (p < 0.001). (4) Conclusions: Pregnant women, particularly if living with overweight, commonly have a poor dietary quality and a light level of physical activity. A history of GDM is not reflected in the lifestyle habits, despite the assumption that they have received lifestyle counselling during a previous pregnancy. Pregnant women would benefit from new means to promote healthy lifestyle changes.

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“…However, a possible mechanism explaining this phenomenon has yet to be elucidated. [51][52][53] Therefore, early detection of individuals at high risk for T2D in the nonobese population is essential to reduce the incidence of T2D, the complications of T2D, and the socioeconomic burden, which prompted us to carry out this study.…”

Section: Discussionmentioning

confidence: 99%

Derivation and Validation of a Prediction Model for Predicting the 5-Year Incidence of Type 2 Diabetes in Non-Obese Adults: A Population-Based Cohort Study

Cai

et al. 2021

DMSO

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The aim of this study was to derivate and validate a nomogram based on independent predictors to better evaluate the 5-year risk of T2D in non-obese adults. Patients and Methods: This is a historical cohort study from a collection of databases that included 12,940 non-obese participants without diabetes at baseline. All participants were randomised to a derivation cohort (n = 9651) and a validation cohort (n = 3289). In the derivation cohort, the least absolute shrinkage and selection operator (LASSO) regression model was used to determine the optimal risk factors for T2D. Multivariate Cox regression analysis was used to establish the nomogram of T2D prediction. The receiver operating characteristic (ROC) curve, C-index, calibration curve, and decision curve analysis were performed by 1000 bootstrap resamplings to evaluate the discrimination ability, calibration, and clinical practicability of the nomogram. Results: After LASSO regression analysis of the derivation cohort, it was found that age, fatty liver, γ-glutamyltranspeptidase, triglycerides, glycosylated hemoglobin A1c and fasting plasma glucose were risk predictors, which were integrated into the nomogram. The C-index of derivation cohort and validation cohort were 0.906 [95% confidence interval (CI), 0.-878-0.934] and 0.837 (95% CI, 0.760-0.914), respectively. The AUC of 5-year T2D risk in the derivation cohort and validation cohort was 0.916 (95% CI, 0.889-0.943) and 0.829 (95% CI, 0.753-0.905), respectively. The calibration curve indicated that the predicted probability of nomogram is in good agreement with the actual probability. The decision curve analysis demonstrated that the predicted nomogram was clinically useful. Conclusion:Our nomogram can be used as a reasonable, affordable, simple, and widely implemented tool to predict the 5-year risk of T2D in non-obese adults. With this model, early identification of high-risk individuals is helpful to timely intervene and reduce the risk of T2D in non-obese adults.

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Lifestyle and glycemic health 5 years postpartum in obese and non-obese high diabetes risk women

Cited by 5 publications

References 44 publications

Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

Living with Overweight, Rather than a History of Gestational Diabetes, Influences Dietary Quality and Physical Activity during Pregnancy

Derivation and Validation of a Prediction Model for Predicting the 5-Year Incidence of Type 2 Diabetes in Non-Obese Adults: A Population-Based Cohort Study

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