Mothers after Gestational Diabetes in Australia (MAGDA): A Randomised Controlled Trial of a Postnatal Diabetes Prevention Program

Sharleen O'Reilly and colleagues investigate the effectiveness of a diabetes prevention program for reducing weight, waist circumference and fasting glucose measurements for women who have had gestational diabetes.

Vyšlo v časopise: Mothers after Gestational Diabetes in Australia (MAGDA): A Randomised Controlled Trial of a Postnatal Diabetes Prevention Program. PLoS Med 13(7): e32767. doi:10.1371/journal.pmed.1002092
Kategorie: Research Article


Sharleen O'Reilly and colleagues investigate the effectiveness of a diabetes prevention program for reducing weight, waist circumference and fasting glucose measurements for women who have had gestational diabetes.


1. International Diabetes Federation. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation; 2015.

2. Cefalu WT, Petersen MP, Ratner RE. The alarming and rising costs of diabetes and prediabetes: a call for action! Diabetes Care. 2014;37:3137–3138. doi: 10.2337/dc14-2329 25414386

3. Bellamy L, Casas J-P, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–1779. doi: 10.1016/S0140-6736(09)60731-5 19465232

4. Ratner R, Goldberg R, Haffner S, Marcovina S, Orchard T, Fowler S, et al. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005;28:888–894. 15793191

5. Lindstrom J, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Keinanen-Kiukaanniemi S, et al. Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia. 2013;56:284–293. doi: 10.1007/s00125-012-2752-5 23093136

6. The Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002;25:2165–2171. 12453955

7. Ratner RE, Christophi CA, Metzger BE, Dabelea D, Bennett PH, Pi-Sunyer X, et al. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab. 2008;93:4774–4779. doi: 10.1210/jc.2008-0772 18826999

8. Malcolm J. Through the looking glass: gestational diabetes as a predictor of maternal and offspring long-term health. Diabetes Metab Res Rev. 2012;28:307–311. doi: 10.1002/dmrr.2275 22228678

9. Black MH, Sacks DA, Xiang AH, Lawrence JM. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care. 2013;36:56–62. doi: 10.2337/dc12-0741 22891256

10. Cnattingius S, Villamor E. Weight change between successive pregnancies and risks of stillbirth and infant mortality: a nationwide cohort study. Lancet. 2015;387:558–565. doi: 10.1016/S0140-6736(15)00990-3 26651225

11. Peters RK, Kjos SL, Xiang A, Buchanan TA. Long-term diabetogenic effect of single pregnancy in women with previous gestational diabetes mellitus. Lancet. 1996;347:227–230. 8551882

12. Bao W, Yeung E, Tobias DK, Hu FB, Vaag AA, Chavarro JE, et al. Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study. Diabetologia. 2015;58:1212–1219. doi: 10.1007/s00125-015-3537-4 25796371

13. Thompson AL. Intergenerational impact of maternal obesity and postnatal feeding practices on pediatric obesity. Nutr Rev. 2013;71 (Suppl 1):S55–S61. doi: 10.1111/nure.12054 24147925

14. Klohe-Lehman DM, Freeland-Graves J, Clarke KK, Cai G, Voruganti VS, Milani TJ, et al. Low-income, overweight and obese mothers as agents of change to improve food choices, fat habits, and physical activity in their 1-to-3-year-old children. J Am Coll Nutr. 2007;26:196–208. 17634164

15. van der Pligt P, Willcox J, Hesketh KD, Ball K, Wilkinson S, Crawford D, et al. Systematic review of lifestyle interventions to limit postpartum weight retention: implications for future opportunities to prevent maternal overweight and obesity following childbirth. Obes Rev. 2013;14:792–805. doi: 10.1111/obr.12053 23773448

16. Lim S, O’Reilly S, Behrens H, Skinner T, Ellis I, Dunbar JA. Effective strategies for weight loss in post-partum women: a systematic review and meta-analysis. Obes Rev. 2015;16:972–987. doi: 10.1111/obr.12312 26313354

17. Nielsen KK, Kapur A, Damm P, de Courten M, Bygbjerg IC. From screening to postpartum follow-up—the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review. BMC Pregnancy Childbirth. 2014;14:41. doi: 10.1186/1471-2393-14-41 24450389

18. Pennington A, O’Reilly SL, Young D, Dunbar J. Improving follow-up care for women with a history of gestational diabetes: perspectives of GPs and patients. Aust J Prim Health. In press. doi: 10.1071/PY15177

19. Lie MLS, Hayes L, Lewis-Barned NJ, May C, White M, Bell R. Preventing type 2 diabetes after gestational diabetes: women’s experiences and implications for diabetes prevention interventions. Diabet Med. 2013;30:986–993. doi: 10.1111/dme.12206 23534548

20. Hu G, Tian H, Zhang F, Liu H, Zhang C, Zhang S, et al. Tianjin Gestational Diabetes Mellitus Prevention Program: study design, methods, and 1-year interim report on the feasibility of lifestyle intervention program. Diabetes Res Clin Pract. 2012;98:508–517. doi: 10.1016/j.diabres.2012.09.015 23010556

21. Ferrara A, Hedderson MM, Albright CL, Ehrlich SF, Quesenberry CP Jr, Peng T, et al. A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial. Diabetes Care. 2011;34:1519–1525. doi: 10.2337/dc10-2221 21540430

22. Smith BJ, Cinnadaio N, Cheung NW, Bauman A, Tapsell LC, van der Ploeg HP. Investigation of a lifestyle change strategy for high-risk women with a history of gestational diabetes. Diabetes Res Clin Pract. 2014;106:e60–e63. doi: 10.1016/j.diabres.2014.09.035 25451910

23. Nicklas JM, Zera CA, England LJ, Rosner BA, Horton E, Levkoff SE, et al. A web-based lifestyle intervention for women with recent gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol. 2014;124:563–570. doi: 10.1097/AOG.0000000000000420 25162257

24. Philis-Tsimikas A, Fortmann A, Dharkar-Surber S, Euyoque J, Ruiz M, Schultz J, et al. Dulce Mothers: an intervention to reduce diabetes and cardiovascular risk in Latinas after gestational diabetes. Behav Med Pract Policy Res. 2014;4:18–25. doi: 10.1007/s13142-014-0253-4

25. Ferrara A, Hedderson MM, Brown SD, Albright CL, Ehrlich SF, Tsai A-L, et al. The comparative effectiveness of diabetes prevention strategies to reduce postpartum weight retention in women with gestational diabetes mellitus: the Gestational Diabetes’ Effects on Moms (GEM) cluster randomized controlled trial. Diabetes Care. 2016;39:65–74. doi: 10.2337/dc15-1254 26657945

26. Ehrlich SF, Hedderson MM, Quesenberry CP, Feng J, Brown SD, Crites Y, et al. Post-partum weight loss and glucose metabolism in women with gestational diabetes: the DEBI Study. Diabet Med. 2014;31:862–867. doi: 10.1111/dme.12425 24597974

27. Lau R, Vaughan C, Reddy P, Dunbar JA, editors. A review of interventions post-gestational diabetes. 6th International Symposium on Diabetes and Pregnancy; 23–26 Mar 2011; Salzburg, Austria.

28. Laatikainen T, Dunbar J, Chapman A, Kilkkinen A, Vartiainen E, Heistaro S, et al. Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) Diabetes Prevention Project. BMC Public Health. 2007;7:249. doi: 10.1186/1471-2458-7-249 17877832

29. Shih S, Davis-Lameloise N, Janus E, Wildey C, Versace V, Hagger V, et al. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention: an update to the study protocol for a randomized controlled trial. Trials. 2014;15:259. doi: 10.1186/1745-6215-15-259 24981503

30. Shih S, Davis-Lameloise N, Janus E, Wildey C, Versace V, Hagger V, et al. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention: study protocol for a randomized controlled trial. Trials. 2013;14:339. doi: 10.1186/1745-6215-14-339 24135085

31. Australian Diabetes in Pregnancy Society. ADIPS consensus guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia. 2014 Jun [cited 3 Dec 2104]. Available:

32. Tolonen H, Kuulasmaa K, Laatikainen T, Wolf H, European Health Risk Monitoring Project. Recommendations for indicators, international collaboration, protocol and manual operations chronic disease risk factor surveys. Helsinki: Finnish National Public Health Institute; 2002.

33. Hebden L, Kostan E, O’Leary F, Hodge A, Allman-Farinelli M. Validity and reproducibility of a food frequency questionnaire as a measure of recent dietary intake in young adults. PLoS ONE. 2013;8:e75156. doi: 10.1371/journal.pone.0075156 24058660

34. Brown WJ, Burton NW, Marshall AL, Miller YD. Reliability and validity of a modified self-administered version of the Active Australia physical activity survey in a sample of mid-age women. Aust N Z J Public Health. 2008;32:535–541. doi: 10.1111/j.1753-6405.2008.00305.x 19076744

35. Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, et al. The Finnish Diabetes Prevention Study (DPS) lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26:3230–3236. 14633807

36. Laatikainen T, Philpot B, Hankonen N, Sippola R, Dunbar JA, Absetz P, et al. Predicting changes in lifestyle and clinical outcomes in preventing diabetes: the Greater Green Triangle Diabetes Prevention Project. Prev Med. 2012;54:157–161. doi: 10.1016/j.ypmed.2011.12.015 22227224

37. Aziz Z, Absetz P, Oldroyd J, Pronk NP, Oldenburg B. A systematic review of real-world diabetes prevention programs: learnings from the last 15 years. Implement Sci. 2015;10:1–17. doi: 10.1186/s13012-015-0354-6 26670418

38. Kanaya AM, Santoyo-Olsson J, Gregorich S, Grossman M, Moore T, Stewart AL. The live well, be well study: a community-based, translational lifestyle program to lower diabetes risk factors in ethnic minority and lower-socioeconomic status adults. Am J Public Health. 2012;102:1551–1558. doi: 10.2105/ajph.2011.300456 22698027

39. Ruggiero L, Oros S, Choi YK. Community-based translation of the diabetes prevention program’s lifestyle intervention in an underserved Latino population. Diabetes Educ. 2011;37:564–572. doi: 10.1177/0145721711411107 21690435

40. Lombard C, Harrison C, Kozica S, Zoungas S, Ranasinha S, Teede H. Preventing weight gain in women in rural communities: a cluster randomised controlled trial. PLoS Med. 2016;13:e1001941. doi: 10.1371/journal.pmed.1001941 26785406

41. Gilinsky AS, Kirk AF, Hughes AR, Lindsay RS. Lifestyle interventions for type 2 diabetes prevention in women with prior gestational diabetes: a systematic review and meta-analysis of behavioural, anthropometric and metabolic outcomes. Prev Med Rep. 2015;2:448–461. doi: 10.1016/j.pmedr.2015.05.009 26844102

42. Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–1686. doi: 10.1016/S0140-6736(09)61457-4 19878986

43. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995;122:481–486. 7872581

44. Bennett WL, Liu SH, Yeh HC, Nicholson WK, Gunderson EP, Lewis CE, et al. Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: the CARDIA study. Obesity (Silver Spring). 2013;21:1269–1275. doi: 10.1002/oby.20133

45. Adamson L, Brown W, Byles J, Chojenta C, Dobson A, Fitzgerald D, et al. Women’s weight: findings from the Australian Longitudinal Study on Women’s Health. Canberra: Australian Government Department of Health and Ageing; 2007.

46. Hutfless S, Maruthur N, Wilson R, Gudzune K, Brown R, Lau B, et al. Strategies to prevent weight gain among adults. Comparative Effectiveness Reviews, No. 97. Contract No. 13-EHC029-EF. Rockville (Maryland): Agency for Healthcare Research and Quality; 2013.

47. Pronk NP, Remington PL, Community Preventive Services Task Force. Combined diet and physical activity promotion programs for prevention of diabetes: Community Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:1–4. doi: 10.7326/M15-1029 26168073

48. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, et al. Weight, weight change, and coronary heart disease in women: risk within the ‘normal’ weight range. JAMA. 1995;273:461–465. 7654270

49. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378:815–825. doi: 10.1016/S0140-6736(11)60814-3 21872750

50. National Institute for Health and Care Excellence. Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period. London: National Institute for Health and Care Excellence; 2015.

51. American Diabetes Association. 4. Prevention or delay of type 2 diabetes. Diabetes Care. 2016;39(Suppl 1):S36–S38. doi: 10.2337/dc16-S007 26696678

52. Guo J, Chen J-L, Whittemore R, Whitaker E. Postpartum lifestyle interventions to prevent type 2 diabetes among women with history of gestational diabetes: a systematic review of randomized clinical trials. J Womens Health (Larchmt). 2015;25:38–49. doi: 10.1089/jwh.2015.5262

53. Chasan-Taber L. Lifestyle interventions to reduce risk of diabetes among women with prior gestational diabetes mellitus. Best Pract Res Clin Obstet Gynaecol. 2015;29:110–122. doi: 10.1016/j.bpobgyn.2014.04.019 25220104

54. Moroshko I, Brennan L, O’Brien P. Predictors of dropout in weight loss interventions: a systematic review of the literature. Obes Rev. 2011;12:912–934. doi: 10.1111/j.1467-789X.2011.00915.x 21815990

55. Jiandani D, Wharton S, Rotondi MA, Ardern CI, Kuk JL. Predictors of early attrition and successful weight loss in patients attending an obesity management program. BMC Obes. 2016;3:1–9. doi: 10.1186/s40608-016-0098-0 26966544

56. Grossi E, Dalle Grave R, Mannucci E, Molinari E, Compare A, Cuzzolaro M, et al. Complexity of attrition in the treatment of obesity: clues from a structured telephone interview. Int J Obes 2006;30:1132–1137. doi: 10.1038/sj.ijo.0803244

57. Grave RD, Suppini A, Calugi S, Marchesini G. Factors associated with attrition in weight loss programs. Int J Behav Consult Ther. 2006;2:341–353. doi: 10.1037/h0100788

58. Australian Institute of Health and Welfare. Australia’s health 2014. Australia’s health series, No. 14, Catalogue No. AUS 178. Canberra: Australian Institute of Health and Welfare; 2014.

59. Noctor E, Dunne FP. Type 2 diabetes after gestational diabetes: the influence of changing diagnostic criteria. World J Diabetes. 2015;6:234–244. doi: 10.4239/wjd.v6.i2.234 25789105

Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine

2016 Číslo 7
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle

Zvýšte si kvalifikáciu online z pohodlia domova

Eozinofilní granulomatóza s polyangiitidou
nový kurz
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.


Nemáte účet?  Registrujte sa