Effects of lifestyle intervention during pregnancy on postpartum diabetes among Chinese women with gestational diabetes
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RESEARCH LETTER
Effects of lifestyle intervention during pregnancy on postpartum diabetes among Chinese women with gestational diabetes Ninghua Li 1 & Jinnan Liu 1 & Cuiping Zhang 2 & Gongshu Liu 2 & Junhong Leng 2 Weiqin Li 2 & Zhijie Yu 3 & Gang Hu 4 & Juliana C. N. Chan 5,6 & Xilin Yang 1,7,8
&
Leishen Wang 2
&
Received: 25 July 2020 / Accepted: 16 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Keywords Diabetes . Gestational diabetes . Impaired fasting glucose . Impaired glucose tolerance . Intensive lifestyle intervention . Postpartum
Abbreviations GCT Glucose challenge test GDM Gestational diabetes mellitus IFG Impaired fasting glucose IGT Impaired glucose tolerance LGA Large-for-gestational-age PG Plasma glucose SMBG Self-monitoring of blood glucose
To the Editor: Gestational diabetes mellitus (GDM) affected approximately 12.8% of pregnancies worldwide in 2019 according to the estimation of the International Diabetes Ninghua Li and Jinnan Liu contributed equally to this study. * Xilin Yang [email protected]; [email protected] 1
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
2
Tianjin Women and Children’s Health Centre, Tianjin, China
3
Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
4
Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
5
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
6
Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China
7
Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
8
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
Federation [1]. Growing evidence suggests that women with a history of GDM have a markedly increased risk of diabetes later in life [2], but it is still unknown whether intensive management of GDM has benefits for prevention of maternal diabetes at postpartum and later in life. Our group conducted a population-based RCT testing the effectiveness of intensive lifestyle intervention of GDM on the risk of macrosomia and large-for-gestational-age (LGA) in the three-tier antenatal care network of Tianjin, China. We found that such an intervention reduced the risk of macrosomia and LGA in offspring of women with GDM [3]. In the current analysis, we investigate the effect of lifestyle intervention on maternal postpartum diabetes among women with prior GDM. Details of the study setting, design and participants are reported elsewhere [3]. Briefly, 19,847 pregnant women were enrolled and offered a 50 g 1 h glucose challenge test (GCT) between the 24th and 28th week of gestation, at primary hospitals. Women who had GCT ≥7.8 mmol/l (n = 2921) were referred to the Tianjin Women and Children’s Health Center (Tianjin, China) to undergo a 75 g 2 h OGTT. Based on the International Association of Diab
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