Abstract
Very few studies have assessed short-term and long-term cardiovascular effects of an early postpartum lifestyle intervention among women with gestational diabetes mellitus and diabetes. The aim of the present study was to examine whether an early postpartum 9-month intensive lifestyle intervention can lead to weight loss and improve cardiovascular risk factors among women with both GDM and newly diagnosed diabetes, and also to investigate these effects in a long term. A total of 83 women who had GDM and were newly diagnosed as type 2 diabetes at 2.6 year after delivery participated in a 9-month intensive lifestyle intervention and a follow-up survey at 6-9 years post-intervention. A total of 68 women finished the 9-month lifestyle intervention and 39 women finished the 6-9 years post-intervention survey. During the first 9-month intervention, women lost their weight at 2.76 kg (-3.81% initial weight) , decreased their waist circumference (-2.88 cm) , body fat (-1.69%) , diastolic blood pressure (-3.49 mm Hg) , fasting glucose (-0.98 mmol/L) and HbA1c (-0.71%) . During the 6-9 years post intervention, women still lost weight (-3.49 kg; -5.14% initial weight) , decreased their waist circumference (-4.03 cm) , and body fat (-1.93%) , but slightly increased their HbA1c (0.26%) , total cholesterol (0.29 mmol/L) and triglycerides (0.17 mmol/L) . The prevalence of using glucose-lowering agents increased from 2.9% at baseline to 35.3% after the 9 month lifestyle intervention, and to 48.7% at 6-9 years post-intervention. An early postpartum 9-month intensive lifestyle intervention could have effects on weight loss, decreased HbA1c and other cardiovascular risk factors among women with GDM and newly diagnosed diabetes. The weight loss effect with a lifestyle intervention can persist for at least 6 years, however, HbA1c levels slightly increased in the long term.