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A web-based lifestyle intervention for women with recent gestational diabetes mellitus: a randomized controlled trial
Jacinda M Nicklas1, Chloe A Zera, Lucinda J England
1Division of Endocrinology, Diabetes and Hypertension, the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, the Channing Division of Network Medicine, Department of Medicine and the Department of Global Health and Social Medicine, Harvard Medical School, the Department of Biostatistics, Harvard School of Public Health, and the Joslin Diabetes Center, Boston, Massachusetts; the Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado; the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and the College of Social Work, University of South Carolina, Columbia, South Carolina.
Objective:
To test the feasibility and effectiveness of a Web-based lifestyle intervention based on the Diabetes Prevention Program modified for women with recent gestational diabetes mellitus to reduce postpartum weight retention.
Methods:
We randomly allocated 75 women with recent gestational diabetes mellitus to either a Web-based lifestyle program (Balance after Baby) delivered over the first postpartum year or to a control group. Primary outcomes were change in body weight at 12 months from 1) first postpartum measured weight; and 2) self-reported prepregnancy weight.
Results:
There were no significant differences in baseline characteristics between groups including age, body mass index, race, and income status. Women assigned to the Balance after Baby program (n=36, three lost to follow-up) lost a mean of 2.8 kg (95% confidence interval -4.8 to -0.7) from 6 weeks to 12 months postpartum, whereas the control group (n=39, one lost to follow-up) gained a mean of 0.5 kg (-1.4 to +2.4) (P=.022). Women in the intervention were closer to prepregnancy weight at 12 months postpartum (mean change -0.7 kg; -3.5 to +2.2) compared with women in the control arm (+4.0 kg; +1.3 to +6.8) (P=.035).
Conclusion:
A Web-based lifestyle modification program for women with recent gestational diabetes mellitus decreased postpartum weight retention.
Clinical Trial Registration:
ClinicalTrials.gov, www.clinicaltrials.gov, NCT01158131.
Level Of Evidence:
I.
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