title: Group-based activities with on-site childcare and online support improve glucose tolerance in women within 5 years of gestational diabetes pregnancy.
abstract: BACKGROUND
  Women with gestational diabetes history are at increased risk for type 2 diabetes. They face specific challenges for behavioural changes, including childcare responsibilities. The aim of this study is to test a tailored type 2 diabetes prevention intervention in women within 5 years of a pregnancy with gestational diabetes, in terms of effects on weight and cardiometabolic risk factors.
  
  
  METHODS
  The 13-week intervention, designed based on focus group discussions, included four group sessions, two with spousal participation and all with on-site childcare. Web/telephone-based support was provided between sessions. We computed mean percentage change from baseline (95% confidence intervals, CI) for anthropometric measures, glucose tolerance (75 g Oral glucose tolerance test), insulin resistance/sensitivity, blood pressure, physical activity, dietary intake, and other cardiometabolic risk factors.
  
  
  RESULTS
  Among the 36 enrolled, 27 completed final evaluations. Most attended ≥ 3 sessions (74%), used on-site childcare (88%), and logged onto the website (85%). Steps/day (733 steps, 95% CI 85, 1391) and fruit/vegetable intake (1.5 servings/day, 95% CI 0.3, 2.8) increased. Proportions decreased for convenience meal consumption (-30%, 95% CI -50, -9) and eating out (-22%, 95% CI -44, -0) ≥ 3 times/month. Body mass index and body composition were unchanged. Fasting (-4.9%, 95% CI -9.5, -0.3) and 2-hour postchallenge (-8.0%, 95% CI -15.6, -0.5) glucose declined. Insulin sensitivity increased (ISI 0,120 23.7%, 95% CI 9.1, 38.4; Matsuda index 37.5%, 95% CI 3.5, 72.4). Insulin resistance (HOMA-IR -9.4%, 95% CI -18.6, -0.1) and systolic blood pressure (-3.3%, 95% CI -5.8, -0.8) decreased.
  
  
  CONCLUSIONS
  A tailored group intervention appears to lead to improvements in health behaviours and cardiometabolic risk factors despite unchanged body mass index and body composition. This approach merits further study.
  
  
  BACKGROUND
  ClinicalTrials.gov (NCT01814995).
authors: Anne-Sophie
authors: AS
authors: Brazeau
authors: Aaron
authors: A
authors: Leong
authors: Sara J
authors: SJ
authors: Meltzer
authors: Rani
authors: R
authors: Cruz
authors: Deborah
authors: D
authors: DaCosta
authors: Mary
authors: M
authors: Hendrickson-Nelson
authors: Lawrence
authors: L
authors: Joseph
authors: Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, 687 Pine Avenue West, H3A 1A1, Montreal, Quebec, Canada. Kaberi.dasgupta@mcgill.ca.
authors: Kaberi
authors: K
authors: Dasgupta
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002654:Child Care / Q000379:methods*; D002675:Child, Preschool; D016640:Diabetes, Gestational / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D017144:Focus Groups / Q000379:methods*; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D020407:Internet; D010865:Pilot Projects; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose