Lifestyle intervention for the prevention of type 2 diabetes in women with prior gestational diabetes: A systematic review and meta-analysis.

Abstract

To determine whether current evidence supports lifestyle intervention for type 2 diabetes (T2D) prevention in women with previous gestational diabetes (GD). We systematically searched MEDLINE/PubMed, Web of Science, EMBASE, The Cochrane Library, International Pharmaceutical Abstracts, Global Health, Sinomed and Clinicaltrials.gov for randomized controlled trials (published from 1 January 1950 to 14 December 2022) comparing lifestyle intervention with standard care in women with previous GD. Our primary outcome was incident T2D, with pooled estimates calculated by a fixed-effects model. Of 1652 studies identified, 13 were eligible and were included in our analysis (N=3745 women). Compared with standard care, lifestyle intervention yielded a reduction of 24% in the incidence of T2D (relative risk 0.76 [95% CI 0.63-0.93]). Meta-regression analyses revealed no impact of the duration of lifestyle intervention (P=.81) or baseline body mass index (P=.90) on the observed reduction in incident T2D. Importantly, this published literature shows evidence of publication bias on funnel plot and Egger test (P=.048). Current published evidence suggests that lifestyle intervention can reduce the risk of T2D in women with prior GD. However, this finding should be interpreted with caution in the presence of documented publication bias.