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 (US) |
|---|---|
| Article number | 75 |
| Journal | Communications Medicine |
| Volume | 4 |
| Issue number | 1 |
| DOIs | |
| State | Published - Dec 2024 |
Funding
The ADA/EASD Precision Diabetes Medicine Initiative, within which this work was conducted, has received the following support: The Covidence license was funded by Lund University (Sweden), for which technical support was provided by Maria Bj\u00F6rklund and Krister Aronsson (Faculty of Medicine Library, Lund University, Sweden). Administrative support was provided by Lund University (Malm\u00F6, Sweden), the University of Chicago (IL, USA), and the American Diabetes Association (Washington D.C., USA). The Novo Nordisk Foundation (Hellerup, Denmark) provided grant support for in-person writing group meetings (PI: L Phillipson, University of Chicago, IL) (NNF22SA0081670).SL is funded by the Australian National Health and Medical Research Council (NHMRC) Fellowship (APP1139481). JW is funded by the NHMRC Ideas Grant. WT, MC, and GU were funded by the Australian Government Research Training Program Scholarship. LR is funded by the National Institute of Health (5R01DK124806). We are highly indebted to extend our gratitude to the authors of primary studies for responding to our data enquiries. Finally, librarians from Monash University are also appreciated for their support during accessing freely available studies. The ADA/EASD Precision Diabetes Medicine Initiative, within which this work was conducted, has received the following support: The Covidence license was funded by Lund University (Sweden), for which technical support was provided by Maria Bj\u00F6rklund and Krister Aronsson (Faculty of Medicine Library, Lund University, Sweden). Administrative support was provided by Lund University (Malm\u00F6, Sweden), the University of Chicago (IL, USA), and the American Diabetes Association (Washington D.C., USA). The Novo Nordisk Foundation (Hellerup, Denmark) provided grant support for in-person writing group meetings (PI: L Phillipson, University of Chicago, IL)\u00A0(NNF22SA0081670).SL is funded by the Australian National Health and Medical Research Council (NHMRC) Fellowship\u00A0(APP1139481). JW is funded by the NHMRC Ideas Grant. WT, MC, and GU were funded by the Australian Government Research Training Program Scholarship. LR is funded by the National Institute of Health (5R01DK124806). We are highly indebted to extend our gratitude to the authors of primary studies for responding to our data enquiries. Finally, librarians from Monash University are also appreciated for their support during accessing freely available studies.
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Internal Medicine
- Epidemiology
- Medicine (miscellaneous)
- Assessment and Diagnosis
