Case Reports on Diabetes-Related Outcomes for Pregnant Women in the National Diabetes Prevention Program.

Abstract

Previous interventions to lower diabetes risks among pregnant women have been largely ineffective (1–3), and the identification of effective prevention tools is needed to protect both maternal and child health (4). The National Diabetes Prevention Program (NDPP) is a widely disseminated translation of the highly successful lifestyle change intervention from the Diabetes Prevention Program research study (5,6). The NDPP promotes weight loss of ≥5% through diet and physical activity, benefiting individuals who participate regularly (6). Eighty percent of participants are women (6), but most are beyond child-bearing years (7), and those who are pregnant at enrollment are excluded (8). Increasing enrollment in the NDPP among women of childbearing age has been identified as a priority (7), yet outcomes for those who become pregnant during the year-long program are unknown. To explore whether the NDPP may support beneficial outcomes during pregnancy, we examined case studies of women who became pregnant while participating in the NDPP. We delivered the year-long NDPP intervention in a Denver, Colo., health care system to eligible adults with diabetes risks (i.e., ≥24 kg/m2 and prediabetes, history of gestational diabetes mellitus [GDM], or positive score on a diabetes risk questionnaire [8]). Participants were largely referred by their primary care providers. Trained NDPP coaches led 22–25 group sessions over 1 year following guidelines developed by the Centers for Disease Control and Prevention (9). From March 2013 to March 2018, 924 women participated. Five women who subsequently reported having become pregnant were able to continue, but were no longer prescribed the NDPP’s weight loss goal. This article describes diabetes-related outcomes in pregnancy among three women using medical records available as of May 2018. An additional case was excluded because detailed records were unavailable, and another was excluded because of the early stage of the pregnancy. …