title: Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): A Randomized Controlled Trial.
abstract: OBJECTIVE
  To assess whether gestational diabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease.
  
  
  METHODS
  Two hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ≥30 kg/m(2) were enrolled in the study at <20 weeks of gestation and were randomly allocated to the intervention group (n = 155) or the control group (n = 138). Each subject in the intervention group received individualized counseling on diet, physical activity, and weight control from trained study nurses, and had one group meeting with a dietitian. The control group received standard antenatal care. The diagnosis of GDM was based on a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation.
  
  
  RESULTS
  A total of 269 women were included in the analyses. The incidence of GDM was 13.9% in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (-0.58 kg [95% CI -1.12 to -0.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group.
  
  
  CONCLUSIONS
  A moderate individualized lifestyle intervention reduced the incidence of GDM by 39% in high-risk pregnant women. These findings may have major health consequences for both the mother and the child.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, and Kätilöopisto Maternity Hospital, Helsinki, Finland saila.koivusalo@hus.fi.
authors.forename: Saila B
authors.initials: SB
authors.lastname: Koivusalo
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, and Kätilöopisto Maternity Hospital, Helsinki, Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Rönö
authors.affiliation: Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland Medical Genetics and Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Miira M
authors.initials: MM
authors.lastname: Klemetti
authors.affiliation: University of Eastern Finland, Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, Kuopio, Finland Helsinki and Uusimaa Hospital District, Helsinki, Finland Kuopio University Hospital, Kuopio, Finland.
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.affiliation: Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Lindström
authors.affiliation: Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: Maijaliisa
authors.initials: M
authors.lastname: Erkkola
authors.affiliation: Turku University Hospital and Turku University, Turku, Finland.
authors.forename: Risto J
authors.initials: RJ
authors.lastname: Kaaja
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Jorvi Hospital, Espoo, Finland.
authors.forename: Maritta
authors.initials: M
authors.lastname: Pöyhönen-Alho
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Women's Hospital, Helsinki, Finland.
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Jorvi Hospital, Espoo, Finland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Huvinen
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.affiliation: Medical Genetics and Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
authors.forename: Hannele
authors.initials: H
authors.lastname: Laivuori
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland.
authors.forename: Anita
authors.initials: A
authors.lastname: Valkama
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Jelena
authors.initials: J
authors.lastname: Meinilä
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
authors.forename: Beata
authors.initials: B
authors.lastname: Stach-Lempinen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003376:Counseling; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005387:Finland / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000517:prevention & control; D011247:Pregnancy; D011295:Prenatal Care; D011322:Primary Prevention; D015430:Weight Gain; D055815:Young Adult