TY - JOUR
T1 - Lifestyle and glycemic health 5 years postpartum in obese and non-obese high diabetes risk women
AU - Huvinen, Emilia
AU - Engberg, Elina
AU - Meinilä, Jelena
AU - Tammelin, Tuija
AU - Kulmala, Janne
AU - Heinonen, Kati
AU - Bergman, Paula
AU - Stach-Lempinen, Beata
AU - Koivusalo, Saila
N1 - Funding Information:
Open access funding provided by University of Helsinki including Helsinki University Central Hospital.
Funding Information:
The study was funded by The Finnish Medical Foundation, Alfred Kordelin Foundation, Juho Vainio Foundation, Ahokas Foundation, the Finnish Foundation for Cardiovascular Disease, Academy of Finland, Special state subsidy for health science research of Helsinki University Hospital (HUH), Samfundet Folkhälsan, Finska Läkaresällskapet, Viipuri Tuberculosis Foundation, The Finnish Diabetes Research Foundation, State Provincial Office of Southern Finland, Health Promotion Grant (Ministry of Social Affairs and Health) EU H2020-PHC-2014-DynaHealth Grant no. 633595 and The Social Insurance Institution of Finland. The funders have not had any role in designing or conducting the study; nor in collection, management, analysis, or interpretation of the data; nor in preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Acknowledgements
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Aim: Women with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI. Methods: The RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI ≥ 30 kg/m2 and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m2. Results: Altogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c. Conclusion: Lifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women. Clinical trial registration: ClinicalTrials.gov, http://www.clinicaltrials.com, NCT01698385.
AB - Aim: Women with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI. Methods: The RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI ≥ 30 kg/m2 and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m2. Results: Altogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c. Conclusion: Lifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women. Clinical trial registration: ClinicalTrials.gov, http://www.clinicaltrials.com, NCT01698385.
KW - Diet
KW - Gestational diabetes
KW - Heterogeneity
KW - Physical activity
KW - Type 2 diabetes
U2 - 10.1007/s00592-020-01553-1
DO - 10.1007/s00592-020-01553-1
M3 - Article
C2 - 32712801
AN - SCOPUS:85088429033
SN - 0940-5429
VL - 57
SP - 1453
EP - 1462
JO - ACTA DIABETOLOGICA
JF - ACTA DIABETOLOGICA
IS - 12
ER -
