Group-based activities with on-site childcare and online support improve glucose tolerance in women within 5?years of gestational diabetes pregnancy.

Auteur(s) :
Brazeau AS., Leong A., Meltzer SJ., Cruz R., DaCosta D., Hendrickson-Nelson M., Joseph L., Dasgupta K.
Date :
Juin, 2014
Source(s) :
Cardiovasc Diabetol.. #13: p104
Adresse :
Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, 687 Pine Avenue West, H3A 1A1, Montreal, Quebec, Canada. [email protected]

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BACKGROUND:

Women with gestational diabetes history are at increased risk for type 2 diabetes. They face specific challenges for behavioural changes, including childcare responsibilities. The aim of this study is to test a tailored type 2 diabetes prevention intervention in women within 5 years of a pregnancy with gestational diabetes, in terms of effects on weight and cardiometabolic risk factors.

METHODS:

The 13-week intervention, designed based on focus group discussions, included four group sessions, two with spousal participation and all with on-site childcare. Web/telephone-based support was provided between sessions. We computed mean percentage change from baseline (95% confidence intervals, CI) for anthropometric measures, glucose tolerance (75 g Oral glucose tolerance test), insulin resistance/sensitivity, blood pressure, physical activity, dietary intake, and other cardiometabolic risk factors.

RESULTS:

Among the 36 enrolled, 27 completed final evaluations. Most attended ≥ 3 sessions (74%), used on-site childcare (88%), and logged onto the website (85%). Steps/day (733 steps, 95% CI 85, 1391) and fruit/vegetable intake (1.5 servings/day, 95% CI 0.3, 2.8) increased. Proportions decreased for convenience meal consumption (-30%, 95% CI -50, -9) and eating out (-22%, 95% CI -44, -0) ≥ 3 times/month. Body mass index and body composition were unchanged. Fasting (-4.9%, 95% CI -9.5, -0.3) and 2-hour postchallenge (-8.0%, 95% CI -15.6, -0.5) glucose declined. Insulin sensitivity increased (ISI 0,120 23.7%, 95% CI 9.1, 38.4; Matsuda index 37.5%, 95% CI 3.5, 72.4). Insulin resistance (HOMA-IR -9.4%, 95% CI -18.6, -0.1) and systolic blood pressure (-3.3%, 95% CI -5.8, -0.8) decreased.

CONCLUSIONS:

A tailored group intervention appears to lead to improvements in health behaviours and cardiometabolic risk factors despite unchanged body mass index and body composition. This approach merits further study.

Source : Pubmed
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