Lifestyle change after gestational diabetes.
OBJECTIVE
Gestational diabetes mellitus (GDM) is a predictor for overt diabetes later in life. Thus, during pregnancy GDM patients are instructed to change lifestyle after pregnancy. The purpose of the present study was to assess the lifestyle changes made by these women.


METHODS
The study was a mailed survey with structured questions on diet, weight loss, exercise and worry about developing diabetes. One hundred and twenty-one (79%) women agreed to participate 11-42 months after pregnancy. Weight gain or loss was defined as a change >/=5 kg.


RESULTS
Among women with body mass index (BMI) >25 kg/m(2), only 18% lost weight and more than 33% gained weight. In total, more women gained than lost weight (P<0.05). Prior to pregnancy, 90 (74%) women followed a diet rich in fat. In contrast, only 57 women (47%) did so at follow-up (P<0.001). Further analysis showed that among these 57 women, only 7% had lost weight since pregnancy compared to 25% of women eating healthy (P<0.05). Eighty-six percent were worried to some extent about the risk for subsequent diabetes. The exercise level did not change after pregnancy. Nineteen women (16%) had overt diabetes mellitus and 22 (18%) impaired glucose tolerance (IGT) at follow-up.


CONCLUSIONS
Although the majority of the women were concerned about developing overt diabetes, only a few had changed their lifestyle and/or lost weight after pregnancy. This indicates that lifestyle instruction needs to be much more frequent and intensive in the period after pregnancy in these women.
Stage
E
E
Obstetric Clinic 4031, The Juliane Marie Centre, Rigshospitalet, Blegdamsvej 9, DK 2100, Copenhagen, Denmark. rh02117@rh.dk
Ronneby
H
H
Damm
P
P
D000328:Adult; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008875:Middle Aged; D011247:Pregnancy; D011795:Surveys and Questionnaires; D015431:Weight Loss
D004041:Dietary Fats