Abstract
BackgroundWe recently demonstrated that a gestational diabetes history in mothers is associated with higher postpartum incident diabetes not only in mothers but also in fathers. In the present study, we examined changes in health behaviours and cardiometabolic profiles in both mothers and partners who participated in a diabetes prevention program within 5 years of a gestational diabetes pregnancy.MethodsCouples were enrolled into a 13-week program that included 5 half-day group sessions and web/telephone-based support between sessions. It was designed in consultation with patients and previously studied in mothers. We computed mean changes from baseline (95% CI) for physical activity, eating, and sleep measures, and cardiometabolic parameters (fasting and 2-h post glucose load plasma glucose, BMI, blood pressure) in both partners and mothers.ResultsAmong 59 couples enrolled, 45 partners (76%) and 47 mothers (80%) completed final evaluations. Baseline cardiometabolic measures averaged within normal limits. Similar to mothers, partners increased physical activity (+ 1645 steps/day, 95%CI 730, 2561; accelerometer assessed moderate-to-vigorous physical activity + 36.4 min/week, 95% CI 1.4, 71.4) and sleep duration (+ 0.5 h/night, 95% CI 0.1, 0.9) and reduced the sodium-to-potassium ratio of food intake (− 0.09 95% CI -0.19, − 0.001). No conclusive changes were observed in glucose measures or insulin resistance; in analyses combining mothers and partners, systolic blood pressure decreased (− 2.7 mmHg, 95% CI -4.4, − 1.0).ConclusionsPartners and mothers demonstrated improved physical activity, sleep, and dietary quality. Baseline cardiometabolic profiles averaged at normal values and there were no changes in glucose or insulin resistance; some blood pressure impact was observed. While strategies need to be developed to attract participants at higher cardiometabolic risk, this study demonstrates that partners of women within 5 years of a gestational diabetes diagnosis can be recruited and do achieve health behaviour change.Trial registrationClinicalTrials.gov: NCT02343354 (date of registration: January 22, 2015).
Highlights
We recently demonstrated that a gestational diabetes history in mothers is associated with higher postpartum incident diabetes in mothers and in fathers
A systematic review indicates that Gestational diabetes (GDM) confers a 7-fold risk increase [1], with 30–70% of women developing type 2 diabetes within 10 years of a GDM pregnancy [2]
The American Diabetes Prevention Program trial demonstrated that an intervention strategy focusing on eating and physical activity habits can markedly reduce diabetes risk following GDM [5], attracting younger mothers is challenging
Summary
We recently demonstrated that a gestational diabetes history in mothers is associated with higher postpartum incident diabetes in mothers and in fathers. We examined changes in health behaviours and cardiometabolic profiles in both mothers and partners who participated in a diabetes prevention program within 5 years of a gestational diabetes pregnancy. The American Diabetes Prevention Program trial demonstrated that an intervention strategy focusing on eating and physical activity habits can markedly reduce diabetes risk following GDM [5], attracting younger mothers is challenging. Studies to date have tailored interventions to mothers, but mothers themselves express a need for partner collaboration for health behaviour change [6]. We Brazeau et al BMC Public Health (2018) 18:575 demonstrated that GDM in mothers is associated with incident diabetes in fathers [7]. Shared risk and shared behaviours arguably constitute levers for collaboration between partners for diabetes prevention
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