Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis

Siew Lim; Wubet Worku Takele; Kimberly K. Vesco; 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 G. Ukke; Shao J. Zhou; ADA/EASD PMDI; Jami Josefson

doi:10.1038/s43856-023-00366-x

Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis

Siew Lim (Leading Author), Wubet Worku Takele, Kimberly K. Vesco, 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 G. Ukke, Shao J. Zhou, ADA/EASD PMDIJami Josefson

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

15 Citations (Scopus)

Abstract

Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.

Original language	English
Article number	137
Number of pages	11
Journal	Communications Medicine
Volume	3
Issue number	1
DOIs	https://doi.org/10.1038/s43856-023-00366-x
Publication status	Published - 5 Oct 2023

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Lim, S., Takele, W. W., Vesco, K. K., 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., ... Josefson, J. (2023). Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis. Communications Medicine, 3(1), Article 137. https://doi.org/10.1038/s43856-023-00366-x

@article{079efe918a6043018ecfbc69c36933de,

title = "Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis",

abstract = "Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.",

author = "Siew Lim and Takele, {Wubet Worku} and Vesco, {Kimberly K.} 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 G.} 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 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 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 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 Jami Josefson",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

month = oct,

day = "5",

doi = "10.1038/s43856-023-00366-x",

language = "English",

volume = "3",

journal = "Communications Medicine",

issn = "2730-664X",

publisher = "Nature Publishing Group",

number = "1",

}

Lim, S, Takele, WW, Vesco, KK, 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 & Josefson, J 2023, 'Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis', Communications Medicine, vol. 3, no. 1, 137. https://doi.org/10.1038/s43856-023-00366-x

TY - JOUR

T1 - Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine

T2 - a systematic review and meta-analysis

AU - Takele, Wubet Worku

AU - Vesco, Kimberly K.

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 G.

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 - 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 - 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 - 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 - Josefson, Jami

A2 - Lim, Siew

PY - 2023/10/5

Y1 - 2023/10/5

N2 - Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.

AB - Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.

UR - http://www.scopus.com/inward/record.url?scp=85173449756&partnerID=8YFLogxK

U2 - 10.1038/s43856-023-00366-x

DO - 10.1038/s43856-023-00366-x

M3 - Article

AN - SCOPUS:85173449756

SN - 2730-664X

VL - 3

JO - Communications Medicine

JF - Communications Medicine

IS - 1

M1 - 137

ER -

Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis

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