A Web-Based Lifestyle Intervention for Women With Recent Gestational Diabetes Mellitus: A Randomized Controlled Trial

Nicklas, Jacinda M.; Zera, Chloe A.; England, Lucinda J.; Rosner, Bernard A.; Horton, Edward; Levkoff, Sue E.; Seely, Ellen W.

doi:10.1097/aog.0000000000000420

Cited by 140Gestational Diabetes Research and ManagementMobile Health and mHealth ApplicationsObesity, Physical Activity, Diet

A Web-Based Lifestyle Intervention for Women With Recent Gestational Diabetes Mellitus: A Randomized Controlled Trial

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Nicklas, Jacinda M., Zera, Chloe A., England, Lucinda J., Rosner, Bernard A., Horton, Edward, Levkoff, Sue E., Seely, Ellen W.·2014·Obstetrics & Gynecology

DOI 10.1097/aog.0000000000000420PMC PMC4401073

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Abstract

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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Two DCP studies reported prevention effectiveness, and both had a neutral effect.
“In addition, 2 (15.4%) studies [40,44] reported prevention effectiveness of DCP, and both had a neutral effect.”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [40]
The Results report no significant between-group differences in impaired glucose tolerance or type 2 diabetes at 12 months, which supports describing the observed diabetes-related effect as neutral. But the Discussion says a larger, longer study is needed to determine whether the program prevents progression to type 2 diabetes; this trial was powered for postpartum weight retention, not prevention effectiveness. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Of 5 PHT studies on T2DM prevention, 1 (20%) posted a positive effect and 4 (80%) reported a neutral effect.
“Of the 5 (13.5%) studies on PHT reporting its effects on preventing T2DM, 1 (20%) study [39] posted a positive effect, with 4 (80%) other studies [35,36,40,41] reporting a neutral effect on T2DM development.”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [40]
Of 12 DCP studies assessing dysglycemia, 9 (75%) reported positive population health outcomes and 3 (25%) showed neutral effects.
“Of the 12 studies (92.3%) assessing the effects of dysglycemia, 9 (75%) reported positive population health outcomes, such as significant HbA1c reduction compared to the control group in Kim et al [45] using virtual reality (VR) technology and Everett et al [46] using AI interventions (P<.05). Furthermore, 3 (25%) studies [40,44,47] showed the effect was neutral.”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [40]
Of 5 TM studies on T2DM development, 1 by Sakane et al indicated TM is effective, and the other 4 did not show significant differences compared to the control group.
“Of the 5 (20%) studies reporting the effects of TM on T2DM development, only 1 (20%) study by Sakane et al [39] indicated that TM is effective. The other 4 (80%) studies [35,40,44,50] did not show any significant differences compared to the control group.”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [40]

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Long-Term Weight Retention After Gestational Diabetes: Role of Postpartum Lifestyle Interventions
Adam, P., & Chaisson, N. (2026) · British Journal of Obstetrics and Gynaecology

Authors: Nicklas, J. M., Zera, C. A., England, L. J., Rosner, B. A., Horton, E., Levkoff, S. E., & Seely, E. W.
Affiliations: Brigham and Women's Hospital (US)
ORCID: Nicklas, Jacinda M.
Zera, Chloe A.
England, Lucinda J.
Rosner, Bernard A.
Horton, Edward
Levkoff, Sue E.
Seely, Ellen W.
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-09
Volume: 124
Issue: 3
Pages: 563-570
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/aog.0000000000000420
PMC: PMC4401073
OpenAlex: W1981309817
Cited by: 140
References: 30
Citations by year: 2026: 10 · 2025: 9 · 2024: 17 · 2023: 14 · 2022: 12 · 2021: 9 · 2020: 13 · 2019: 10 · 2018: 17 · 2017: 9 · 2016: 7 · 2015: 12 · 2014: 1
FWCI: 10.26
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (CC999999)
U.S. Public Health Service (MM-1094-09/09)
National Heart, Lung, and Blood Institute (K24HL096141)
National Center for Complementary and Integrative Health (T32AT000051)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD057022)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: gestational diabetes mellitus, postpartum weight retention, Diabetes Prevention Program, postpartum weight loss, pre-pregnancy weight, women
MeSH terms: Adult, Behavior Therapy, Female, Humans, Life Style, Obesity, Pregnancy, Preventive Health Services, Program Evaluation, Weight Gain, Body Mass Index, Diabetes, Gestational, Treatment Outcome, Risk Reduction Behavior, Postpartum Period

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A Web-Based Lifestyle Intervention for Women With Recent Gestational Diabetes Mellitus: A Randomized Controlled Trial

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