Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis
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Date
2024
Authors
Takele, W.W.
Vesco, K.K.
Josefson, J.
Redman, L.M.
Hannah, W.
Bonham, M.P.
Chen, M.
Chivers, S.C.
Fawcett, A.J.
Grieger, J.A.
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Communications Medicine, 2024; 4(1):75-1-75-15
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Wubet Worku Takele, Kimberly K. Vesco, Jami Josefson, Leanne M. Redman, Wesley Hannah, Maxine P. Bonham, Mingling Chen, Sian C. Chivers, Andrea J. Fawcett, Jessica A. Grieger, Nahal Habibi, Gloria K.W. Leung, Kai Liu, Eskedar G. Mekonnen, Maleesa Pathirana, Alejandra Quinteros, Rachael Taylor, Gebresilasea G. Ukke, Shao J. Zhou, ADA/EASD PMDI and Siew Lim
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Abstract
BACKGROUND: Lifestyle choices, metformin, and dietary supplements may prevent GDM, but the effect of intervention characteristics has not been identified. This review evaluated intervention characteristics to inform the implementation of GDM prevention interventions. METHODS: Ovid, MEDLINE/PubMed, and EMBASE databases were searched. The Template for Intervention Description and Replication (TIDieR) framework was used to examine intervention characteristics (who, what, when, where, and how). Subgroup analysis was performed by intervention characteristics. RESULTS: 116 studies involving 40,940 participants are included. Group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) reduce the incidence of GDM compared with individual or mixed (individual and group) delivery format (subgroup p-value = 0.04). Physical activity interventions delivered at healthcare facilities reduce the risk of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p-value = 0.03). No other intervention characteristics impact the effectiveness of all other interventions. CONCLUSIONS: Dietary, physical activity, diet plus physical activity, metformin, and myoinositol interventions reduce the incidence of GDM compared with control interventions. Group and healthcare facility-based physical activity interventions show better effectiveness in preventing GDM than individual and community-based interventions. Other intervention characteristics (e.g. utilization of e-health) don't impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.
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© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.