Abstract Body (Do not enter title and authors here): Introduction:
One in every three parous women has a pregnancy complication, increasing their chances of developing diabetes mellitus (DM), hypertension, or heart disease. Lifestyle intervention is recommended to reduce morbidity risk after complicated pregnancies. The effect of lifestyle intervention on the risk of type 2 DM in women with prior gestational DM (GDM) is not widely studied. Our study highlights the impact of lifestyle intervention on type 2 DM risk in females with prior GDM.
Methods:
We conducted a systemic literature search of PubMed, EMBASE, Clinical Trials.gov, and Google Scholar from January 2000 to August 2023 for relevant articles comparing lifestyle intervention (diet and physical activity) with standard care in women with prior GDM. The relative risk (RR) of DM with 95% confidence interval (CI) and p-values were extracted with a fixed effect model using RevMan v.5.4.
Results:
Of 3100 articles that underwent screening, 28 underwent full-text review, and 11 studies met the inclusion criteria. Of 11 studies, 1661 were evaluated in intervention group (IG) and 1671 in control group (CG). The mean age of participants was 26.1-39 years, with a baseline body mass index (BMI) range (R) of 23.4-31.4 kg/m2 and a follow-up duration with R of 4-36 months. On analysis, the incidence of type 2 DM was 7.6% in IG compared to CG, with an incidence of 10.35%. IG reported a 27% reduction in DM incidence as compared to CG, with a reported RR of 0.73(CI: 0.59-0.91) (p < 0.05) (Figure 1). On meta-regression analysis, duration of lifestyle intervention (R: 4-36 months) significantly impacted the observed reduction in incident type 2 DM (p < 0.05) (positive relation) as compared to baseline BMI (p = 0.21) (Figure 1).
Conclusion:
Our analysis highlights that lifestyle intervention in women with prior GDM has a positive effect on the reduction of type 2 DM risk, and intervention duration significantly impacts the long-term risk of DM. Further data is warranted from larger studies for stronger evidence regarding the benefits of lifestyle intervention in prior GDM patients.