A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes

Xilin Yang; Huiguang Tian; Fuxia Zhang; Cuiping Zhang; Yi Li; Junhong Leng; Leishen Wang; Gongsu Liu; Ling Dong; Zhijie Yu; Gang Hu; Juliana C.N. Chan

doi:10.1186/s12967-014-0290-2

A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes

Xilin Yang, Huiguang Tian, Fuxia Zhang, Cuiping Zhang, Yi Li, Junhong Leng, Leishen Wang, Gongsu Liu, Ling Dong, Zhijie Yu, Gang Hu, Juliana C.N. Chan

Medicine

Research output: Contribution to journal › Article › peer-review

63 Citations (Scopus)

Abstract

Background: There are no randomised controlled trials to demonstrate whether lifestyle modifications can improve pregnancy outcomes of gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group's (IADPSG) criteria. We tested the effectiveness of lifestyle modifications implemented in a 3-tier's shared care (SC) on pregnancy outcomes of GDM. Methods: Between December 2010 and October 2012, we randomly assigned 700 women with IADPSG-defined GDM but without diabetes at 26.3 (interquartile range: 25.4-27.3) gestational weeks in Tianjin, China, to receive SC or usual care (UC). The SC group received individual consultations and group sessions and performed regular self-monitoring of blood glucose compared to one hospital-based education session in the UC group. The outcomes were macrosomia defined as birth weight ≥ 4.0 kg and the pregnancy-induced hypertension (PIH). Results: Women in the SC (n = 339) and UC (n = 361) groups delivered their infants at similar gestational weeks. Birth weight of infants in the SC group was lower than that in the UC group (3469 vs. 3371 grams, P = 0.021). The rate of macrosomia was 11.2% (38/339) in the SC group compared to 17.5% (63/361) in the UC group with relative risk (RR) of 0.64 (95% CI: 0.44-0.93). The rate of PIH was 8.0% (27/339) in the SC compared to 4.4% (16/361) in the UC with RR of 1.80 (0.99-3.28). Apgar score at 1 min < 7 was lower but preeclampsia was higher in the SC than in the UC. Conclusions: Lifestyle modifications using a SC system improved pregnancy outcomes in Chinese women with GDM.

Original language	English
Article number	290
Journal	Journal of Translational Medicine
Volume	12
Issue number	1
DOIs	https://doi.org/10.1186/s12967-014-0290-2
Publication status	Published - Oct 28 2014

Bibliographical note

Funding Information:
This project is supported by BRIDGES [Grant number: LT09-227]. BRIDGES is an International Diabetes Federation program supported by an educational grant from Lilly Diabetes. The authors thank all the health professionals of Tianjin Antenatal Care Network for their involvement in and contribution to the study. X.Y. was the guarantor of this manuscript.

Funding Information:
JCNC was a member of the IDF-Western Pacific Region Executive Board and IDF Adhoc committee for global plan of action for prevention of diabetes and chronic diseases. Her institution has received research funding from Eli Lilly and she is a member of advisory committee and speaker forum sponsored by Eli Lilly. Other authors have nothing to declare.

Publisher Copyright:
© 2014 Yang et al.

ASJC Scopus Subject Areas

General Biochemistry,Genetics and Molecular Biology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12967-014-0290-2

Cite this

Yang, X., Tian, H., Zhang, F., Zhang, C., Li, Y., Leng, J., Wang, L., Liu, G., Dong, L., Yu, Z., Hu, G., & Chan, J. C. N. (2014). A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes. Journal of Translational Medicine, 12(1), Article 290. https://doi.org/10.1186/s12967-014-0290-2

A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes. / Yang, Xilin; Tian, Huiguang; Zhang, Fuxia et al.
In: Journal of Translational Medicine, Vol. 12, No. 1, 290, 28.10.2014.

Research output: Contribution to journal › Article › peer-review

Yang, X, Tian, H, Zhang, F, Zhang, C, Li, Y, Leng, J, Wang, L, Liu, G, Dong, L, Yu, Z, Hu, G & Chan, JCN 2014, 'A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes', Journal of Translational Medicine, vol. 12, no. 1, 290. https://doi.org/10.1186/s12967-014-0290-2

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abstract = "Background: There are no randomised controlled trials to demonstrate whether lifestyle modifications can improve pregnancy outcomes of gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group's (IADPSG) criteria. We tested the effectiveness of lifestyle modifications implemented in a 3-tier's shared care (SC) on pregnancy outcomes of GDM. Methods: Between December 2010 and October 2012, we randomly assigned 700 women with IADPSG-defined GDM but without diabetes at 26.3 (interquartile range: 25.4-27.3) gestational weeks in Tianjin, China, to receive SC or usual care (UC). The SC group received individual consultations and group sessions and performed regular self-monitoring of blood glucose compared to one hospital-based education session in the UC group. The outcomes were macrosomia defined as birth weight ≥ 4.0 kg and the pregnancy-induced hypertension (PIH). Results: Women in the SC (n = 339) and UC (n = 361) groups delivered their infants at similar gestational weeks. Birth weight of infants in the SC group was lower than that in the UC group (3469 vs. 3371 grams, P = 0.021). The rate of macrosomia was 11.2% (38/339) in the SC group compared to 17.5% (63/361) in the UC group with relative risk (RR) of 0.64 (95% CI: 0.44-0.93). The rate of PIH was 8.0% (27/339) in the SC compared to 4.4% (16/361) in the UC with RR of 1.80 (0.99-3.28). Apgar score at 1 min < 7 was lower but preeclampsia was higher in the SC than in the UC. Conclusions: Lifestyle modifications using a SC system improved pregnancy outcomes in Chinese women with GDM.",

author = "Xilin Yang and Huiguang Tian and Fuxia Zhang and Cuiping Zhang and Yi Li and Junhong Leng and Leishen Wang and Gongsu Liu and Ling Dong and Zhijie Yu and Gang Hu and Chan, {Juliana C.N.}",

note = "Funding Information: This project is supported by BRIDGES [Grant number: LT09-227]. BRIDGES is an International Diabetes Federation program supported by an educational grant from Lilly Diabetes. The authors thank all the health professionals of Tianjin Antenatal Care Network for their involvement in and contribution to the study. X.Y. was the guarantor of this manuscript. Funding Information: JCNC was a member of the IDF-Western Pacific Region Executive Board and IDF Adhoc committee for global plan of action for prevention of diabetes and chronic diseases. Her institution has received research funding from Eli Lilly and she is a member of advisory committee and speaker forum sponsored by Eli Lilly. Other authors have nothing to declare. Publisher Copyright: {\textcopyright} 2014 Yang et al.",

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AU - Yang, Xilin

AU - Tian, Huiguang

AU - Zhang, Fuxia

AU - Zhang, Cuiping

AU - Li, Yi

AU - Leng, Junhong

AU - Wang, Leishen

AU - Liu, Gongsu

AU - Dong, Ling

AU - Yu, Zhijie

AU - Hu, Gang

AU - Chan, Juliana C.N.

N1 - Funding Information: This project is supported by BRIDGES [Grant number: LT09-227]. BRIDGES is an International Diabetes Federation program supported by an educational grant from Lilly Diabetes. The authors thank all the health professionals of Tianjin Antenatal Care Network for their involvement in and contribution to the study. X.Y. was the guarantor of this manuscript. Funding Information: JCNC was a member of the IDF-Western Pacific Region Executive Board and IDF Adhoc committee for global plan of action for prevention of diabetes and chronic diseases. Her institution has received research funding from Eli Lilly and she is a member of advisory committee and speaker forum sponsored by Eli Lilly. Other authors have nothing to declare. Publisher Copyright: © 2014 Yang et al.

PY - 2014/10/28

Y1 - 2014/10/28

N2 - Background: There are no randomised controlled trials to demonstrate whether lifestyle modifications can improve pregnancy outcomes of gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group's (IADPSG) criteria. We tested the effectiveness of lifestyle modifications implemented in a 3-tier's shared care (SC) on pregnancy outcomes of GDM. Methods: Between December 2010 and October 2012, we randomly assigned 700 women with IADPSG-defined GDM but without diabetes at 26.3 (interquartile range: 25.4-27.3) gestational weeks in Tianjin, China, to receive SC or usual care (UC). The SC group received individual consultations and group sessions and performed regular self-monitoring of blood glucose compared to one hospital-based education session in the UC group. The outcomes were macrosomia defined as birth weight ≥ 4.0 kg and the pregnancy-induced hypertension (PIH). Results: Women in the SC (n = 339) and UC (n = 361) groups delivered their infants at similar gestational weeks. Birth weight of infants in the SC group was lower than that in the UC group (3469 vs. 3371 grams, P = 0.021). The rate of macrosomia was 11.2% (38/339) in the SC group compared to 17.5% (63/361) in the UC group with relative risk (RR) of 0.64 (95% CI: 0.44-0.93). The rate of PIH was 8.0% (27/339) in the SC compared to 4.4% (16/361) in the UC with RR of 1.80 (0.99-3.28). Apgar score at 1 min < 7 was lower but preeclampsia was higher in the SC than in the UC. Conclusions: Lifestyle modifications using a SC system improved pregnancy outcomes in Chinese women with GDM.

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A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes

Abstract

Bibliographical note

ASJC Scopus Subject Areas

UN SDGs

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