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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
Open accessAbstract
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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“However, studies that tested the effectiveness of lifestyle interventions provided during pregnancy on GDM have shown mixed results [14, 17–21].”
From Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus—a systematic review and meta-analysis of 257,876 pregnancies (2023) · cites this paper as [17]
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Metadata
- 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)
- 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
- 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
- bronze
- doi.org
- 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 › Medicine › Pediatrics, Perinatology and Child Health › 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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