Based on a new study by Kaiser Permanente published in Diabetes Care, a diabetes prevention program that was given within the nation's largest health care system was able to effectively help women who have had gestational diabetes reach weight loss goals and increase physical activity after childbirth.
Women who have gestational diabetes mellitus, a specific type that happens during pregnancy, are up to 7 times more likely to have type 2 diabetes in the years that follow after giving birth. Around 75% of women who suffer from this are from racial or ethnic groups.
Obesity is actually one of the key risk factors in developing type 2 diabetes. The diabetes intervention program, called Gestational Diabetes Effects on Moms (GEM) study aimed to identify some health-system-based methods for assisting women who are suffering from gestational diabetes, and allow them to meet their weight goals a year following childbirth. The program helped 1,087 women from 22 clinics in Kaiser Permanente's Northern California region. The program included receiving direct mails, as well as telephone coaching. Most women also received printouts that described what diabetes risk was and ways in preventing it.
Gestational Diabetes Goals
During the six months after giving birth, women who had gestational diabetes and going to these clinics who had the intervention were 45% more likely to reach their weight goals as compared to those who went to clinics with usual care. The vigorous-intensity physical activity of these women were also
increased by an average of 15.4 minutes per week.
Dr. Assiamira Ferrara, who is the study's lead author and also the section chief of Women's and Children's Health at the Kaiser Permanente California Division of Research, says that the GEM trial is unique in such a way that it was embedded in real-world practice. The findings of the study show that lifestyle intervention for gestational diabetes patients help them manage their weight and increase physical activity as well. This implies that the onset of diabetes may be potentially prevented or delayed.
Yvonne Crites, MD, perinatologist at Kaiser Permanente's Santa Clara Medical Center and medical director of the Perinatal Center, says that the study's findings will inform how we help Kaiser Permanente members who had gestational diabetes reduce their chances of developing type 2 diabetes.
Patients who participated in the program were mailed information about weight gain during the course of pregnancy, and were also offered the opportunity to acquire a lifestyle workbook, as well as the chance to participate in 13 telephone sessions with a lifestyle coach, which were conducted between 6 weeks and 6 months after giving birth.
Around half of the women who were offered lifestyle intervention participated, which meant that these women wanted to learn more about the risks associated with gestational diabetes. Further analysis of the data also showed that the intervention would have been twice as effective if all women who were offered with the intervention actually participated, and that the number of weight goals achieved would also consequently increase. This would suggest a potential for great impact if doctors can actually improve the participation of patients in lifestyle intervention programs such as GEM.
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By: Yevgeny Dulla MSc