Lifestyle intervention in prevention of type 2 diabetes in women with a history of gestational diabetes mellitus: one-year results of the FIN-D2D project.
BACKGROUND
Lifestyle interventions are effective in preventing type 2 diabetes (T2D). Women with history of gestational diabetes mellitus (GDM) may have barriers to lifestyle changes, and the previous results of lifestyle interventions are contradictory reporting either favorable outcomes or no significant beneficial effects. Our aim was to compare cardio-metabolic risk profile and responses to a 1-year lifestyle intervention program in women with and without history of GDM.


METHODS
The Implementation Project of the Program for Prevention of Type 2 Diabetes (FIN-D2D) was conducted in Finland in five hospital districts. Altogether 1,661 women aged ≤45 years participated in the program. One-year follow-up was available for 393 women who did not have screen-detected T2D at baseline, and 265 of them had at least one intervention visit [115 (43.4%) women with history of GDM and 150 (56.6%) without history of GDM].


RESULTS
At baseline, women with GDM had similar baseline glucose tolerance but better anthropometric characteristics, blood pressure, and lipid profile than women without GDM after adjustment for age. Beneficial changes in cardiovascular risk profile existed among women with and without GDM during follow-up and the effect of lifestyle intervention was similar between the groups, except that low-density lipoprotein cholesterol improved only in women with GDM. Altogether, 4.0% of those with GDM and 5.0% of those without GDM developed T2D (p=0.959 adjustment for age).


CONCLUSIONS
The effect of a 1-year lifestyle intervention in primary healthcare setting was similar regardless of history of GDM, both women with and without GDM benefitted from participation in the lifestyle intervention.
1 Pirkanmaa Hospital District , Tampere, Finland .
Nina
N
Rautio
Jari
J
Jokelainen
Eeva
E
Korpi-Hyövälti
Heikki
H
Oksa
Timo
T
Saaristo
Markku
M
Peltonen
Leena
L
Moilanen
Mauno
M
Vanhala
Matti
M
Uusitupa
Jaakko
J
Tuomilehto
Sirkka
S
Keinänen-Kiukaanniemi
D000328:Adult; D000367:Age Factors; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000628:therapy*; D005951:Glucose Tolerance Test; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D024821:Metabolic Syndrome / Q000453:epidemiology; D011247:Pregnancy; D011320:Primary Health Care; D015397:Program Evaluation; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult