title: Lifestyle modifications in the development of diabetes mellitus and metabolic syndrome in Chinese women who had gestational diabetes mellitus: a randomized interventional trial.
abstract: OBJECTIVE
  To study whether lifestyle intervention can reduce the development of type II diabetes mellitus (DM) and metabolic syndrome (MS) among Chinese women who had gestational diabetes mellitus (GDM).
  
  
  METHODS
  A prospective randomized controlled interventional trial of 450 women who had GDM and impaired glucose tolerance (IGT) postpartum. Advice on diet and exercise was given to the intervention group and reinforced in each follow-up visit. Women in both arms were followed for 36 months. Blood pressure and anthropometry were measured at each visit and blood tests were repeated.
  
  
  RESULTS
  Fewer women in the intervention group developed DM (15 versus 19 %) but this was not statistically significant, and there was a lower incidence of DM among women over 40 years old. No difference was found in fasting glucose, insulin and homeostasis model assessment (HOMA) index. Both systolic and diastolic blood pressures, and triglyceride level, were lower but the significance was inconsistent among visits. BMI and percentage body fat were also significantly lower in the later visits. There was no difference in waist-hip ratio and basal metabolic rate.
  
  
  CONCLUSIONS
  Our results demonstrate a trend towards lower incidence of type II DM within 3 years postpartum in GDM women given lifestyle advice, which also potentially offers protection against development of MS, in terms of lower blood pressure and triglyceride level. Women over 40 years old are more likely to benefit. Future studies should address ways to maximize compliance to lifestyle intervention as its potential benefits can be undermined by challenges of motherhood.
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong SAR, China, noelshek@gmail.com.
authors.forename: Noel Wan Man
authors.initials: NW
authors.lastname: Shek
authors.forename: Cora Suk Wai
authors.initials: CS
authors.lastname: Ngai
authors.forename: Chin Peng
authors.initials: CP
authors.lastname: Lee
authors.forename: Jane Yuk Chun
authors.initials: JY
authors.lastname: Chan
authors.forename: Terence Tzu Hsi
authors.initials: TT
authors.lastname: Lao
mesh_terms: D000328:Adult; D000367:Age Factors; D000886:Anthropometry; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors