Effects of a Lifestyle Intervention to Prevent Deterioration in Glycemic Status Among South Asian Women With Recent Gestational Diabetes

作者：Nikhil Tandon, Yashdeep Gupta, Deksha Kapoor, Josyula K. Lakshmi, Devarsetty Praveen, Amritendu Bhattacharya, Laurent Billot, Aliya Naheed, Asita de Silva, Rajeev Gupta, Noshin Farzana, Renu John, Saumiyah Ajanthan, Hema Divakar, Neerja Bhatla, Ankush Desai, A. Pathmeswaran, Dorairaj Prabhakaran, Rohina Joshi, Stephen Jan, Helena Teede, Sophia Zoungas, Anushka Patel, LIVING Collaborative Group, Md. Muniruzzaman Siddiqui, Ishrat Jahan, Mohammad Hussain Chowdhury, Md Faruque Pathan, Bishwajit Bhowmik, Prema Varthakavi, Nikhil Bhagwat, Vaibhavi Mungekar, Rekha Fernandes, Vrinda Pednekar, Nalini S. Shah, Tushar Bandgar, Swati Jhadav, Arti Utekar, Urjita Ramchandra Sarnobat, Neelam Jaguste, Arti More, Kedar Narvenkar Narvenkar, Guruprasad Padnekar, Ajit Nagarsenkar, Sachina Vithu Satarkar, Praciya Shyam Goankar, Sneha Chari, Retakshi Ghadi, Nupur Phadte, Mabel Anne Alvares, Mrunali Gaude, Shiwani Dadwal, Sailee Prabhu, Sanjay Kumar Bhadada, Neelam Aggarwal, Chandana Datta, Seema Dahiya, Deepak Khandelwal, Soniya Chahal, Renu Mann, Rajiv Singla, Monika Bhatia, Geetu Gupta, Bharti Kharal, Sadishkumar Kamalanathan, Rajan Palui, Jaya Prakash Sahoo, Papa Dasari, Niya Narayan, Varun Suryadevara, K Shobana Priya, R Priya, Viswanathan Mohan, Uma Ram, Guha Pradeepa, Rajasree Gopinath, R Krishnaveni, U. Ashwini, E Chandralekha, P Nandhini, Mala Dharmalingam, Chitra Selvan, Pramila Kalra, Mamta Sanjeeva, Dev Sreenivasa, Gandluri sowmya, Nihal Thomas, Sahana Shetty, Felix Jebasingh, Riddhi Dasgupta, Jiji Mathew, Kavitha Sankar, Jansi Rani, Nithya Devanithi, Flory Christina, Shirley Newton, Anisha Gala, S Tarakeswari, Vidyavati Patil, Muralidhar Reddy, K. Vijayalakshmi, Ginny Rani, Sunil Fernando, Carmaline Motha, Sanjeeda Baduge, Sachini Rangana Withanage Withanage, Dilumi Jayawickrama, Saumya Hapuarachchi, Sripali Amarasinghe, Athula Kaluarachchi, MNM Rishad, Sachini Ranasinghe, Madara Jayanetti, Aaisha Azam, Ravija Ramasinghe, H.V.L Rangika, R. C. Fernandopulle, Madura Jayawardena, Sheran Siyambalapitiya, Gayan Liyanage, Piyumalie Hettiarachchi, Dimuthu Kaluarachchi, Uthpala Chandradeva, Kalawila Withanage, R. M. M. K. Amarasinghe, Deepa Nandani, Jeyakumar Sabaretnam, Malaka Amarasena, M. D. Radhika Sriyakanthi, Kanchana Peiris, T. Kadotgajan, Milinda Gamlath, Asha Weerasinghe, A.H. Samanthi, Anu Kaushik, Neha Sethi, Ishita Agarwal, Vandana Garg, Kanika Chopra, Divya Soni, Purnima Rao Jevaji, Pavitra Madhira, Thanushanthan Jeevaraja, Shehan Gnanapragasam, Shabnam Sheuly, Nazia Ferdowsh, Tarana Mustari, Shahnaz Parvin Munni, Azmira Khatun, Marzia Sultana, Rifat Hasan Shammi, Sabrina Ahmed, Nantu Chakma, Helen Monaghan, Sindhu Prasad, Amrutha Nagarajaiah, Prakash Velappan, Koushik Gade, Swathi Pagadala, Prithvishree B Radhakrishna, Ambika Yoganathan, Sumathi Senthil, Ravikumar Tummapudi, Ullas Arabhavi, Catherine Lombard, Dewan S Alam · 发表于：JAMA Network Open · 年份：2022 · DOI：10.1001/jamanetworkopen.2022.0773 · 被引用次数：74 · 研究领域：Gestational Diabetes Research and Management、Diabetes Management and Education、Cancer Research and Treatment

Importance: Women with recent gestational diabetes (GDM) have increased risk of developing type 2 diabetes. Objective: To investigate whether a resource-appropriate and context-appropriate lifestyle intervention could prevent glycemic deterioration among women with recent GDM in South Asia. Design, Setting, and Participants: This randomized, participant-unblinded controlled trial investigated a 12-month lifestyle intervention vs usual care at 19 urban hospitals in India, Sri Lanka, and Bangladesh. Participants included women with recent diagnosis of GDM who did not have type 2 diabetes at an oral glucose tolerance test (OGTT) 3 to 18 months postpartum. They were enrolled from November 2017 to January 2020, and follow-up ended in January 2021. Data were analyzed from April to July 2021. Interventions: A 12-month lifestyle intervention focused on diet and physical activity involving group and individual sessions, as well as remote engagement, adapted to local context and resources. This was compared with usual care. Main Outcomes and Measures: The primary outcome was worsening category of glycemia based on OGTT using American Diabetes Association criteria: (1) normal glucose tolerance to prediabetes (ie, impaired fasting glucose or impaired glucose tolerance) or type 2 diabetes or (2) prediabetes to type 2 diabetes. The primary analysis consisted of a survival analysis of time to change in glycemic status at or prior to the final patient visit, which occurred at varying times a...