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Lifestyle interventions for gestational diabetes mellitus to control blood glucose: a meta-analysis of randomized studies

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Abstract

The purpose of this study was to study the effect of lifestyle intervention on the blood glucose control of women with gestational diabetes mellitus (GDM). A meta-analysis was conducted by including randomized controlled trials that compare any form of lifestyle intervention with the usual care. A search of PubMed, MEDLINE, Elsevier Science Direct, Springer, and Web of Science for studies published from 2000 to 2016 was undertaken to identify relevant studies. Methodological quality of the studies was assessed according to the Jadad scale. Random-effort models were used to analyze the weighted mean difference and its 95% confidence interval (CI). From 776 studies, 7 randomized controlled trials (RCTs) (3685 women) were selected for meta-analysis based on our inclusion and exclusion criteria. The evidence suggests that lifestyle, dietary, and activity intervention for women with GDM lowers the fasting plasma glucose (FPG) and 2-h postprandial glucose (2hPG). The reduction in FPG was observed to be statistically significant in the meta-analysis (4 RCTs; n = 1086; −0.16 [95% CI, −0.31 to −0.01]). The reduction in 2hPG was also observed to be statistically significant in the meta-analysis (3 RCTs; n = 849; −0.32 [95% CI, −0.61 to −0.03]). However, no effects of lifestyle interventions were identified in women with GDM in relation to body mass index and hemoglobin A1c. This meta-analysis provides further evidence that lifestyle intervention is associated with reducing FPG and 2hPG in women with GDM.

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Acknowledgements

My deepest gratitude goes first and foremost to Professor Xia Wang, my supervisor, for her constant encouragement and guidance. She has walked me through all the stages of the writing of this paper. Without her consistent and illuminating instruction, this thesis could not have reached its present form. I also owe my sincere gratitude to my friends Baihui Zhang who gave me their help and time in listening to me and helping me work out my problems during the difficult course of the thesis.

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  1. Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, People’s Republic of China

    Wenwen Guo, Baihui Zhang & Xia Wang

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  1. Wenwen Guo
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Correspondence to Xia Wang.

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Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Guo, W., Zhang, B. & Wang, X. Lifestyle interventions for gestational diabetes mellitus to control blood glucose: a meta-analysis of randomized studies. Int J Diabetes Dev Ctries 38, 26–35 (2018). https://doi.org/10.1007/s13410-017-0553-6

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