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Cited by 105Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsMaternal and Neonatal Healthcare

Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot

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Simmons, David, Jelsma, Judith G.M., Galjaard, Sander, Devlieger, Roland, van Assche, Andre, Jans, Goele, Corcoy, Rosa, Adelantado, Juan M. +17 more·2015·Diabetes Care
DOI 10.2337/dc15-0360
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Abstract

OBJECTIVE: Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. RESEARCH DESIGN AND METHODS: Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35–37 weeks. RESULTS: Among the 150 trial participants, 32% developed GDM by 35–37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (−2.6 kg [95% CI −4.9, −0.2]; P = 0.03) and lower fasting glucose (−0.3 mmol/L [−0.4, −0.1]; P = 0.01) than those in the PA group at 24–28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed. CONCLUSIONS: An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

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Authors
Simmons, D., Jelsma, J. G. M., Galjaard, S., Devlieger, R., van Assche, A., Jans, G., Corcoy, R., Adelantado, J. M., Dunne, F., Desoye, G., Harreiter, J., Kautzky-Willer, A., Damm, P., Mathiesen, E. R., Jensen, D. M., Andersen, L. L., Lapolla, A., Dalfra, M., Bertolotto, A., Wender-Ozegowska, E., Zawiejska, A., Hill, D., Rebollo, P., Snoek, F. J., & van Poppel, M. N. M.
Affiliations
  • Addenbrooke's Hospital (GB)
  • Amsterdam Public Health (NL)
  • Universitair Ziekenhuis Leuven (BE)
  • KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
  • Instituto de Salud Carlos III (ES)
  • Hospital de Sant Pau (ES)
  • Ollscoil na Gaillimhe – University of Galway (IE)
  • Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
  • Medical University of Vienna (AT)
  • Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
  • University of Copenhagen (DK)
  • Odense University Hospital (DK)
  • University of Padua (IT)
  • Universita Degli Studi di Padova, Padua, Italy
  • Azienda Ospedaliera Universitaria Pisana (IT)
  • Department of Obstetrics and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
  • Poznan University of Medical Sciences (PL)
  • Recherche en Santé Lawson SA, Bronschhofen, Switzerland
  • BAP Health Outcomes Research SL, Oviedo, Spain
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2015-06-25
Volume
38
Issue
9
Pages
1650-1656
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc15-0360
OpenAlex
W2120632238
Cited by
105
References
22
Citations by year
2026: 1 · 2025: 4 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 11 · 2019: 14 · 2018: 16 · 2017: 11 · 2016: 24 · 2015: 1
FWCI
19.67
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
  • Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Padua Research Archive (University of Padova) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Arrow@dit (Dublin Institute of Technology) (submittedVersion)
  • ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
  • Lirias (submittedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
  • Zenodo (CERN European Organization for Nuclear Research) (other-oa)
Funders
  • CAIBER (1527-B-226)
  • Netherlands Organisation for Health Research and Development (200310013)
  • European Community's 7th Framework Programme (242187)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
gestational diabetes mellitus, gestational weight gain, healthy eating, physical activity, lifestyle intervention, motivational interviewing, telephone coaching, insulin sensitivity, fasting blood glucose, overweight in pregnancy, maternal obesity
MeSH terms
Adult, Europe, Feeding Behavior, Female, Glucose Tolerance Test, Humans, Insulin Resistance, Life Style, Motor Activity, Obesity, Pilot Projects, Pregnancy, Weight Gain, Diabetes, Gestational, Risk Reduction Behavior, Motivational Interviewing

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