OR02-3 Postpartum Lifestyle Intervention in Women with Gestational Diabetes Mellitus: a pilot feasibility study

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR02-Diabetes in Pregnancy
Translational
Saturday, June 15, 2013: 11:30 AM-1:00 PM
Presentation Start Time: 12:00 PM
Room 303 (Moscone Center)
Geetha Mukerji*1, Jennifer Price2, Faith Delos-Reyes2, Sarah McTavish3 and Lorraine Lucille Lipscombe4
1University of Toronto, Toronto, ON, Canada, 2Women's College Hospital, Toronto, Canada, 3Women's College Research Institute, Toronto, Canada, 4Women's College Hospital, Toronto, ON, Canada
Introduction: Women with Gestational Diabetes Mellitus (GDM) are at high risk for future type 2 diabetes and cardiovascular disease (CVD) which can be prevented with lifestyle modification. However, prevention programs in this population have had limited success due to poor adherence. Programs need to be more customized to address the unique needs and barriers faced by new mothers.

Objective: To determine the feasibility of a pilot home-based lifestyle program to improve fitness among women with recent GDM. 

Methods: The study population included women 18 years or older with a pre-pregnancy BMI ≥ 25 kg/m2 during their first postpartum year after GDM. Participants were enrolled between July 2012 to January 2013 into a 6-month home-based lifestyle program, delivered by a kinesiologist trained in motivational interviewing, at the Women’s College Hospital Cardiovascular Prevention and Education Program. The intervention consisted of an individualized exercise prescription based on baseline fitness levels with regular telephone support. Outcomes [exercise capacity (EC) on a graded exercise treadmill test (metabolic equivalents, METS), body mass index (BMI), waist circumference (WC)] were assessed at baseline, 3 months and 6 months.

Results: We present interim data from this ongoing study. Of the 47 women contacted, 21 (45%) were enrolled and 17 (36%) attended the first visit (mean age 38 ± 8 SD years; BMI 35 ± 8 SD kg/m2; postpartum 7 ± 2 SD months). Mean baseline EC was 10.4 ± 1.0 SE METS, with 41% of women at <85% age-predicted EC. For the 8 women who have completed their 3 month visit, EC increased by a mean 0.53 ± 0.47 SE METs (p=0.29), and by 2.0 ± 1.15 METS (p<0.01) among those at <85% age-predicted EC (n=3).  Mean WC decreased by 2.75 ± 0.84 SE cm (p<0.05) with no significant change in BMI (n=8). The retention at 3 months is 100% with 88% reporting excellent or very good program satisfaction.

Conclusions: Our preliminary findings show that a customized lifestyle program in women with recent GDM is feasible with good adherence rates. Interim results indicate early improvements in EC, especially among those with lower baseline fitness levels, and significant reduction in WC after 3 months. Further analysis of the complete cohort at 6 months may demonstrate greater impact.  As increases in EC is associated with a lower risk of all-cause mortality and CVD events, these findings provide evidence for prevention programs designed for women with recent GDM.

Nothing to Disclose: GM, JP, FD, SM, LLL

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Banting and Best Diabetes Centre