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

David Simmons; Judith G M Jelsma; Sander Galjaard; Roland Devlieger; Andre van Assche; Goele Jans; Rosa Corcoy; Juan M Adelantado; Fidelma Dunne; Gernot Desoye; Jürgen Harreiter; Alexandra Kautzky-Willer; Peter Damm; Elisabeth R Mathiesen; Dorte M Jensen; Lise Lotte Andersen; Annunziata Lapolla; Maria Dalfra; Alessandra Bertolotto; Ewa Wender-Ozegowska; Agnieszka Zawiejska; David Hill; Pablo Rebollo; Frank J Snoek; Mireille N M van Poppel

doi:10.2337/dc15-0360

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

David Simmons, Judith G M Jelsma, Sander Galjaard, Roland Devlieger, Andre van Assche, Goele Jans, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Lise Lotte Andersen, Annunziata Lapolla, Maria Dalfra, Alessandra Bertolotto, Ewa Wender-OzegowskaAgnieszka Zawiejska, David Hill, Pablo Rebollo, Frank J Snoek, Mireille N M van Poppel

Institut for Klinisk Medicin

65 Citationer (Scopus)

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 (22.6 kg [95% CI 24.9, 20.2]; P = 0.03) and lower fasting glucose (20.3mmol/L [20.4,20.1]; 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 comparedwith PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

Originalsprog	Engelsk
Tidsskrift	Diabetes Care
Vol/bind	38
Udgave nummer	9
Sider (fra-til)	1650-6
Antal sider	7
ISSN	0149-5992
DOI	https://doi.org/10.2337/dc15-0360
Status	Udgivet - sep. 2015

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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., ... van Poppel, M. N. M. (2015). 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. Diabetes Care, 38(9), 1650-6. https://doi.org/10.2337/dc15-0360

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. / Simmons, David; Jelsma, Judith G M; Galjaard, Sander et al.

I: Diabetes Care, Bind 38, Nr. 9, 09.2015, s. 1650-6.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Simmons, D, Jelsma, JGM, Galjaard, S, Devlieger, R, van Assche, A, Jans, G, Corcoy, R, Adelantado, JM, Dunne, F, Desoye, G, Harreiter, J, Kautzky-Willer, A, Damm, P , Mathiesen, ER, Jensen, DM, Andersen, LL, Lapolla, A, Dalfra, M, Bertolotto, A, Wender-Ozegowska, E, Zawiejska, A, Hill, D, Rebollo, P, Snoek, FJ & van Poppel, MNM 2015, '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', Diabetes Care, bind 38, nr. 9, s. 1650-6. https://doi.org/10.2337/dc15-0360

@article{ca0749188dbb4d4cb915e10f92197a74,

title = "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",

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 (22.6 kg [95% CI 24.9, 20.2]; P = 0.03) and lower fasting glucose (20.3mmol/L [20.4,20.1]; 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 comparedwith PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.",

keywords = "Adult, Diabetes, Gestational, Europe, Feeding Behavior, Female, Glucose Tolerance Test, Humans, Insulin Resistance, Life Style, Motivational Interviewing, Motor Activity, Obesity, Pilot Projects, Pregnancy, Risk Reduction Behavior, Weight Gain",

author = "David Simmons and Jelsma, {Judith G M} and Sander Galjaard and Roland Devlieger and {van Assche}, Andre and Goele Jans and Rosa Corcoy and Adelantado, {Juan M} and Fidelma Dunne and Gernot Desoye and J{\"u}rgen Harreiter and Alexandra Kautzky-Willer and Peter Damm and Mathiesen, {Elisabeth R} and Jensen, {Dorte M} and Andersen, {Lise Lotte} and Annunziata Lapolla and Maria Dalfra and Alessandra Bertolotto and Ewa Wender-Ozegowska and Agnieszka Zawiejska and David Hill and Pablo Rebollo and Snoek, {Frank J} and {van Poppel}, {Mireille N M}",

note = "{\textcopyright} 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.",

year = "2015",

month = sep,

doi = "10.2337/dc15-0360",

language = "English",

volume = "38",

pages = "1650--6",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association",

number = "9",

}

TY - JOUR

T1 - Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus

T2 - The DALI Lifestyle Pilot

AU - Simmons, David

AU - Jelsma, Judith G M

AU - Galjaard, Sander

AU - Devlieger, Roland

AU - van Assche, Andre

AU - Jans, Goele

AU - Corcoy, Rosa

AU - Adelantado, Juan M

AU - Dunne, Fidelma

AU - Desoye, Gernot

AU - Harreiter, Jürgen

AU - Kautzky-Willer, Alexandra

AU - Damm, Peter

AU - Mathiesen, Elisabeth R

AU - Jensen, Dorte M

AU - Andersen, Lise Lotte

AU - Lapolla, Annunziata

AU - Dalfra, Maria

AU - Bertolotto, Alessandra

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David

AU - Rebollo, Pablo

AU - Snoek, Frank J

AU - van Poppel, Mireille N M

PY - 2015/9

Y1 - 2015/9

N2 - 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 (22.6 kg [95% CI 24.9, 20.2]; P = 0.03) and lower fasting glucose (20.3mmol/L [20.4,20.1]; 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 comparedwith PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

AB - 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 (22.6 kg [95% CI 24.9, 20.2]; P = 0.03) and lower fasting glucose (20.3mmol/L [20.4,20.1]; 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 comparedwith PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.

KW - Adult

KW - Diabetes, Gestational

KW - Europe

KW - Feeding Behavior

KW - Female

KW - Glucose Tolerance Test

KW - Humans

KW - Insulin Resistance

KW - Life Style

KW - Motivational Interviewing

KW - Motor Activity

KW - Obesity

KW - Pilot Projects

KW - Pregnancy

KW - Risk Reduction Behavior

KW - Weight Gain

U2 - 10.2337/dc15-0360

DO - 10.2337/dc15-0360

M3 - Journal article

C2 - 26112044

SN - 0149-5992

VL - 38

SP - 1650

EP - 1656

JO - Diabetes Care

JF - Diabetes Care

IS - 9

ER -

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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