Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis

Wubet Worku Takele; Kimberly K. Vesco; Jami L. 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 Getie Mekonnen; Maleesa Pathirana; Alejandra Quinteros; Rachael Taylor; Gebresilasea Gendisha Ukke; Shao J. Zhou; ADA/EASD PMDI; Siew S. Lim

doi:10.1038/s43856-024-00491-1

Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis

Wubet Worku Takele, Kimberly K. Vesco, Jami L. 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 Getie Mekonnen, Maleesa Pathirana, Alejandra Quinteros, Rachael Taylor, Gebresilasea Gendisha Ukke, Shao J. Zhou, ADA/EASD PMDISiew S. Lim

Research output: Contribution to journal › Article › Research › peer-review

12 Citations (Scopus)

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.

Original language	English
Article number	75
Number of pages	15
Journal	Communications Medicine
Volume	4
Issue number	1
DOIs	https://doi.org/10.1038/s43856-024-00491-1
Publication status	Published - 20 Apr 2024

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Takele, W. W., Vesco, K. K., Josefson, J. L., Redman, L. M., Hannah, W., Bonham, M. P., Chen, M., Chivers, S. C., Fawcett, A. J., Grieger, J. A., Habibi, N., Leung, G. K. W., Liu, K., Mekonnen, E. G., Pathirana, M., Quinteros, A., Taylor, R., Ukke, G. G., Zhou, S. J., ... Lim, S. S. (2024). Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis. Communications Medicine, 4(1), Article 75. https://doi.org/10.1038/s43856-024-00491-1

@article{8699d46647f9477fb54de25a3581f227,

title = "Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis",

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{\textquoteright}t impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.",

author = "Takele, {Wubet Worku} and Vesco, {Kimberly K.} and Josefson, {Jami L.} and Redman, {Leanne M.} and Wesley Hannah and Bonham, {Maxine P.} and Mingling Chen and Chivers, {Sian C.} and Fawcett, {Andrea J.} and Grieger, {Jessica A.} and Nahal Habibi and Leung, {Gloria K.W.} and Kai Liu and Mekonnen, {Eskedar Getie} and Maleesa Pathirana and Alejandra Quinteros and Rachael Taylor and Ukke, {Gebresilasea Gendisha} and Zhou, {Shao J.} and Franks, {Paul W.} and Rich, {Stephen S.} and Robert Wagner and Tina Vilsb{\o}ll and Udler, {Miriam S.} and Tiinamaija Tuomi and Arianne Sweeting and Sims, {Emily K.} and Sherr, {Jennifer L.} and Semple, {Robert K.} and Reynolds, {Rebecca M.} and Redondo, {Maria J.} and Pratley, {Richard E.} and Rodica Pop-Busui and Pollin, {Toni I.} and Wei Perng and Pearson, {Ewan R.} and Ozanne, {Susan E.} and Owen, {Katharine R.} and Richard Oram and Rinki Murphy and Viswanathan Mohan and Shivani Misra and Meigs, {James B.} and Nestoras Mathioudakis and Chantal Mathieu and Ma, {Ronald C.W.} and Loos, {Ruth J.F.} and Laffel, {Lori M.} and Kwak, {Soo Heon} and Josefson, {Jami L.} and Hood, {Korey K.} and Hivert, {Marie France} and Hirsch, {Irl B.} and Hattersley, {Andrew T.} and Kurt Griffin and Greeley, {Siri Atma W.} and Gottlieb, {Peter A.} and Gomez, {Maria F.} and Gloyn, {Anna L.} and Florez, {Jose C.} and Dennis, {John M.} and Tina Costacou and Kristen Boyle and Billings, {Liana K.} and Brown, {Rebecca J.} and Philipson, {Louis H.} and Nolan, {John J.} and Eckel, {Robert H.} and Diana Sherifali and Emily Mixter and Mekonnen, {Eskedar Getie} and Chandra Gruber and Fawcett, {Andrea J.} and {de Souza}, Russell and Sungyoung Auh and Yeyi Zhu and Cuilin Zhang and C{\'e}cile Saint-Martin and Michele Provenzano and Hugo Pomares-Millan and Nj{\o}lstad, {P{\aa}l Rasmus} and Mariam Nakabuye and Janne Molnes and Andrew McGovern and Maloney, {Kristin A.} and Flanagan, {Sarah E.} and {de Franco}, Elisa and Ingvild Aukrust and Michel Polak and Jacques Beltrand and Yingchai Zhang and Gechang Yu and White, {Sara L.} and Wesley Hannah and Wentworth, {John M.} and Camille Vatier and {Van der Schueren}, Bart and Marzhan Urazbayeva and Tye, {Sok Cin} and Julie St{\o}y and Norbert Stefan and Steck, {Andrea K.} and Nele Steenackers and Stanislawski, {Maggie A.} and Cate Speake and Sheu, {Wayne Huey Herng} and Elizabeth Selvin and Scholtens, {Denise M.} and Monaco, {Gabriela S.F.} and Sudipa Sarkar and Sarah Kanbour and Vanessa Santhakumar and Zeb Saeed and Mathias Ried-Larsen and Debashree Ray and Rashmi Jain and Powe, {Camille E.} and Petrie, {John R.} and Dianna Perez and Sofia Pazmino and Pankow, {James S.} and Suna Onengut-Gumuscu and Motala, {Ayesha A.} and Morton, {Robert W.} and Lowe, {William L.} and Long, {S. Alice} and Libman, {Ingrid M.} and Aaron Leong and Koivula, {Robert W.} and Jones, {Angus G.} and Johnson, {Randi K.} and Benjamin Hoag and Ismail, {Heba M.} and Arianna Harris-Kawano and Chuiguo Huang and Torben Hansen and Marta Guasch-Ferr{\'e} and Grieger, {Jessica A.} and Goodarzi, {Mark O.} and Gitelman, {Stephen E.} and Fitzpatrick, {Stephanie L.} and Hugo Fitipaldi and Fern{\'a}ndez-Balsells, {Mar{\'i}a Merc{\`e}} and Carmella Evans-Molina and Monika Dudenh{\"o}ffer-Pfeifer and DiMeglio, {Linda A.} and Dickens, {Laura T.} and Deutsch, {Aaron J.} and Dawed, {Adem Y.} and Dana Dabelea and Christoffer Clemmensen and Tinashe Chikowore and Feifei Cheng and Andersen, {Mette K.} and Chlo{\'e} Amouyal and Katherine Young and Yamamoto, {Jennifer M.} and Wong, {Jessie J.} and Wang, {Caroline C.} and Wallace, {Amelia S.} and Mustafa Tosur and Thuesen, {Anne Cathrine B.} and Tam, {Claudia Ha ting} and Pernille Svalastoga and Magdalena Sevilla-Gonzalez and Zhila Semnani-Azad and Martin Sch{\"o}n and Rooney, {Mary R.} and Sridharan Raghavan and Katsiaryna Prystupa and Pilla, {Scott J.} and Patel, {Kashyap Amratlal} and Bige Ozkan and Naylor, {Rochelle N.} and Jasper Most and Morieri, {Mario Luca} and Miller, {Rachel G.} and Mclennan, {Niamh Maire} and Robert Massey and M{\"a}nnist{\"o}, {Jonna M.E.} and Lim, {Lee Ling} and Kreienkamp, {Raymond J.} and Kettunen, {Jarno L.T.} and Kahkoska, {Anna R.} and Jacobsen, {Laura M.} and Ikle, {Jennifer M.} and Alice Hughes and Eram Haider and Romy Gaillard and V{\'e}ronique Gingras and Pieter Gillard and Francis, {Ellen C.} and Felton, {Jamie L.} and Daisy Duan and Cromer, {Sara J.} and Rosa Corcoy and Kevin Colclough and Clark, {Amy L.} and Dhanasekaran Bodhini and Benham, {Jamie L.} and Catherine Aiken and Abrar Ahmad and Jordi Merino and Tobias, {Deirdre K.} and {ADA/EASD PMDI} and Lim, {Siew S.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = apr,

day = "20",

doi = "10.1038/s43856-024-00491-1",

language = "English",

volume = "4",

journal = "Communications Medicine",

issn = "2730-664X",

publisher = "Nature Publishing Group",

number = "1",

}

Takele, WW, Vesco, KK, Josefson, JL, Redman, LM, Hannah, W, Bonham, MP, Chen, M, Chivers, SC, Fawcett, AJ, Grieger, JA, Habibi, N, Leung, GKW, Liu, K, Mekonnen, EG, Pathirana, M, Quinteros, A, Taylor, R, Ukke, GG, Zhou, SJ, ADA/EASD PMDI & Lim, SS 2024, 'Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis', Communications Medicine, vol. 4, no. 1, 75. https://doi.org/10.1038/s43856-024-00491-1

TY - JOUR

T1 - Effective interventions in preventing gestational diabetes mellitus

T2 - A systematic review and meta-analysis

AU - Takele, Wubet Worku

AU - Vesco, Kimberly K.

AU - Josefson, Jami L.

AU - Redman, Leanne M.

AU - Hannah, Wesley

AU - Bonham, Maxine P.

AU - Chen, Mingling

AU - Chivers, Sian C.

AU - Fawcett, Andrea J.

AU - Grieger, Jessica A.

AU - Habibi, Nahal

AU - Leung, Gloria K.W.

AU - Liu, Kai

AU - Mekonnen, Eskedar Getie

AU - Pathirana, Maleesa

AU - Quinteros, Alejandra

AU - Taylor, Rachael

AU - Ukke, Gebresilasea Gendisha

AU - Zhou, Shao J.

AU - Franks, Paul W.

AU - Rich, Stephen S.

AU - Wagner, Robert

AU - Vilsbøll, Tina

AU - Udler, Miriam S.

AU - Tuomi, Tiinamaija

AU - Sweeting, Arianne

AU - Sims, Emily K.

AU - Sherr, Jennifer L.

AU - Semple, Robert K.

AU - Reynolds, Rebecca M.

AU - Redondo, Maria J.

AU - Pratley, Richard E.

AU - Pop-Busui, Rodica

AU - Pollin, Toni I.

AU - Perng, Wei

AU - Pearson, Ewan R.

AU - Ozanne, Susan E.

AU - Owen, Katharine R.

AU - Oram, Richard

AU - Murphy, Rinki

AU - Mohan, Viswanathan

AU - Misra, Shivani

AU - Meigs, James B.

AU - Mathioudakis, Nestoras

AU - Mathieu, Chantal

AU - Ma, Ronald C.W.

AU - Loos, Ruth J.F.

AU - Laffel, Lori M.

AU - Kwak, Soo Heon

AU - Josefson, Jami L.

AU - Hood, Korey K.

AU - Hivert, Marie France

AU - Hirsch, Irl B.

AU - Hattersley, Andrew T.

AU - Griffin, Kurt

AU - Greeley, Siri Atma W.

AU - Gottlieb, Peter A.

AU - Gomez, Maria F.

AU - Gloyn, Anna L.

AU - Florez, Jose C.

AU - Dennis, John M.

AU - Costacou, Tina

AU - Boyle, Kristen

AU - Billings, Liana K.

AU - Brown, Rebecca J.

AU - Philipson, Louis H.

AU - Nolan, John J.

AU - Eckel, Robert H.

AU - Sherifali, Diana

AU - Mixter, Emily

AU - Mekonnen, Eskedar Getie

AU - Gruber, Chandra

AU - Fawcett, Andrea J.

AU - de Souza, Russell

AU - Auh, Sungyoung

AU - Zhu, Yeyi

AU - Zhang, Cuilin

AU - Saint-Martin, Cécile

AU - Provenzano, Michele

AU - Pomares-Millan, Hugo

AU - Njølstad, Pål Rasmus

AU - Nakabuye, Mariam

AU - Molnes, Janne

AU - McGovern, Andrew

AU - Maloney, Kristin A.

AU - Flanagan, Sarah E.

AU - de Franco, Elisa

AU - Aukrust, Ingvild

AU - Polak, Michel

AU - Beltrand, Jacques

AU - Zhang, Yingchai

AU - Yu, Gechang

AU - White, Sara L.

AU - Hannah, Wesley

AU - Wentworth, John M.

AU - Vatier, Camille

AU - Van der Schueren, Bart

AU - Urazbayeva, Marzhan

AU - Tye, Sok Cin

AU - Støy, Julie

AU - Stefan, Norbert

AU - Steck, Andrea K.

AU - Steenackers, Nele

AU - Stanislawski, Maggie A.

AU - Speake, Cate

AU - Sheu, Wayne Huey Herng

AU - Selvin, Elizabeth

AU - Scholtens, Denise M.

AU - Monaco, Gabriela S.F.

AU - Sarkar, Sudipa

AU - Kanbour, Sarah

AU - Santhakumar, Vanessa

AU - Saeed, Zeb

AU - Ried-Larsen, Mathias

AU - Ray, Debashree

AU - Jain, Rashmi

AU - Powe, Camille E.

AU - Petrie, John R.

AU - Perez, Dianna

AU - Pazmino, Sofia

AU - Pankow, James S.

AU - Onengut-Gumuscu, Suna

AU - Motala, Ayesha A.

AU - Morton, Robert W.

AU - Lowe, William L.

AU - Long, S. Alice

AU - Libman, Ingrid M.

AU - Leong, Aaron

AU - Koivula, Robert W.

AU - Jones, Angus G.

AU - Johnson, Randi K.

AU - Hoag, Benjamin

AU - Ismail, Heba M.

AU - Harris-Kawano, Arianna

AU - Huang, Chuiguo

AU - Hansen, Torben

AU - Guasch-Ferré, Marta

AU - Grieger, Jessica A.

AU - Goodarzi, Mark O.

AU - Gitelman, Stephen E.

AU - Fitzpatrick, Stephanie L.

AU - Fitipaldi, Hugo

AU - Fernández-Balsells, María Mercè

AU - Evans-Molina, Carmella

AU - Dudenhöffer-Pfeifer, Monika

AU - DiMeglio, Linda A.

AU - Dickens, Laura T.

AU - Deutsch, Aaron J.

AU - Dawed, Adem Y.

AU - Dabelea, Dana

AU - Clemmensen, Christoffer

AU - Chikowore, Tinashe

AU - Cheng, Feifei

AU - Andersen, Mette K.

AU - Amouyal, Chloé

AU - Young, Katherine

AU - Yamamoto, Jennifer M.

AU - Wong, Jessie J.

AU - Wang, Caroline C.

AU - Wallace, Amelia S.

AU - Tosur, Mustafa

AU - Thuesen, Anne Cathrine B.

AU - Tam, Claudia Ha ting

AU - Svalastoga, Pernille

AU - Sevilla-Gonzalez, Magdalena

AU - Semnani-Azad, Zhila

AU - Schön, Martin

AU - Rooney, Mary R.

AU - Raghavan, Sridharan

AU - Prystupa, Katsiaryna

AU - Pilla, Scott J.

AU - Patel, Kashyap Amratlal

AU - Ozkan, Bige

AU - Naylor, Rochelle N.

AU - Most, Jasper

AU - Morieri, Mario Luca

AU - Miller, Rachel G.

AU - Mclennan, Niamh Maire

AU - Massey, Robert

AU - Männistö, Jonna M.E.

AU - Lim, Lee Ling

AU - Kreienkamp, Raymond J.

AU - Kettunen, Jarno L.T.

AU - Kahkoska, Anna R.

AU - Jacobsen, Laura M.

AU - Ikle, Jennifer M.

AU - Hughes, Alice

AU - Haider, Eram

AU - Gaillard, Romy

AU - Gingras, Véronique

AU - Gillard, Pieter

AU - Francis, Ellen C.

AU - Felton, Jamie L.

AU - Duan, Daisy

AU - Cromer, Sara J.

AU - Corcoy, Rosa

AU - Colclough, Kevin

AU - Clark, Amy L.

AU - Bodhini, Dhanasekaran

AU - Benham, Jamie L.

AU - Aiken, Catherine

AU - Ahmad, Abrar

AU - Merino, Jordi

AU - Tobias, Deirdre K.

AU - ADA/EASD PMDI

AU - Lim, Siew S.

PY - 2024/4/20

Y1 - 2024/4/20

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85204733185&partnerID=8YFLogxK

U2 - 10.1038/s43856-024-00491-1

DO - 10.1038/s43856-024-00491-1

M3 - Article

C2 - 38643248

AN - SCOPUS:85204733185

SN - 2730-664X

VL - 4

JO - Communications Medicine

JF - Communications Medicine

IS - 1

M1 - 75

ER -

Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis

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