The efficacy of interventions to prevent type 2 diabetes among women with recent gestational diabetes mellitus—A living systematic review and meta‐analysis

Autor: Vivian Y. Lee, Mohammad R. Monjur, Joseph Alvin Santos, Anushka Patel, Rong Liu, Gian Luca Di Tanna, Yashdeep Gupta, Alpesh Goyal, Saumiyah Ajanthan, Devarsetty Praveen, J. K. Lakshmi, H. Asita deSilva, Nikhil Tandon
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Diabetes, Vol 16, Iss 8, Pp n/a-n/a (2024)
Druh dokumentu: article
ISSN: 1753-0407
1753-0393
DOI: 10.1111/1753-0407.13590
Popis: Abstract Background While previously considered a transient condition, with no lasting adverse impact, gestational diabetes mellitus (GDM) is now a well‐established risk factor for developing type 2 diabetes mellitus (T2DM). The risk of developing T2DM appears to be particularly high in the first few years after childbirth, providing a compelling case for early intervention. This review provides an up‐to‐date systematic review and meta‐analysis to assess the effectiveness of interventions to reduce incidence of T2DM in women with a recent history of GDM. Methods The search was conducted on October 20, 2023 with an annual surveillance planned for the next 5 years to maintain a living systematic review. The inclusion criteria were randomized controlled trials of any type in women within 5 years of GDM‐complicated pregnancy that reported outcomes of T2DM diagnosis or measures of dysglycemia with a follow‐up of at least 12 months. Results Seventeen studies met our inclusion criteria and have been included in this review. There were 3 pharmacological and 14 lifestyle interventions. Intervention was not associated with significant reduction in the primary outcome of T2DM (risk ratio, 0.78; 95% confidence interval [CI]: 0.43–1.41; p = 0.41; I2 = 79%) compared with the control group (placebo or usual care). However, meta‐analysis of the four studies reporting hazard ratios suggested a reduction in diabetes incidence (hazard ratio, 0.68; 95% CI: 0.48–0.97; p = 0.03; I2 = 31%). Conclusion This review provides equivocal evidence about the efficacy of interventions to reduce the risk of T2DM in women within 5 years of GDM‐complicated pregnancy and highlights the need for further studies, including pharmacotherapy.
Databáze: Directory of Open Access Journals
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