Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions
Women with past gestational diabetes mellitus (GDM) are at risk of subsequent type 2 diabetes and adverse cardiovascular events. Digital and telemedicine interventions targeting weight loss and reductions in body mass index (BMI) may help reduce risk for women with GDM. The aim was to compare the ef...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-03-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/9/1/e002077.full |
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| author | Nia Roberts Andrew J Farmer Julia Halligan Maxine E Whelan |
| author_facet | Nia Roberts Andrew J Farmer Julia Halligan Maxine E Whelan |
| author_sort | Nia Roberts |
| collection | DOAJ |
| description | Women with past gestational diabetes mellitus (GDM) are at risk of subsequent type 2 diabetes and adverse cardiovascular events. Digital and telemedicine interventions targeting weight loss and reductions in body mass index (BMI) may help reduce risk for women with GDM. The aim was to compare the effectiveness of digital or telemedicine intervention with usual care. Randomized controlled trials (RCTs) were identified in Embase, Medline, CINAHL, PsycINFO and the Cochrane Library. Included trials recruited women with prior GDM but without pre-existing diabetes, and tested a digital or telemedicine intervention with or without an in-person component. Data extraction was carried out independently by two authors. The search yielded 898 citations. Eighteen articles reporting 15 trials were included, of which 8 tested digital interventions. Reported outcomes included weight, BMI, fasting plasma glucose and waist circumference. None of the included trials reported type 2 diabetes incidence or cardiovascular risk. Data were pooled using a random-effects model. The point estimate favored the intervention but was non-significant for both BMI (−0.90 kg/m2, 95% CI −1.89 to 0.09; p=0.08) and weight (−1.83 kg, 95% CI −4.08 to 0.42, p=0.11). Trials evaluating digital and telemedicine interventions identified clinically relevant, but non-significant improvements in BMI and weight compared with control. No trials assessed type 2 diabetes occurrence as an outcome. More well-designed RCTs with adequate power and long-term follow-up are needed to identify the impact of these interventions on type 2 diabetes occurrence. |
| format | Article |
| id | doaj-art-3e4abaea876b4b489160c1d67f2b27f8 |
| institution | OA Journals |
| issn | 2052-4897 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-3e4abaea876b4b489160c1d67f2b27f82025-08-20T01:58:45ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-002077Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventionsNia Roberts0Andrew J Farmer1Julia Halligan2Maxine E Whelan35 Bodleian Health Care Libraries, University of Oxford, UK, Oxford, UK4 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKSt Hilda’s College, Oxford University, Oxford, Oxfordshire, UKCentre for Intelligent Healthcare, Coventry University, Coventry, UKWomen with past gestational diabetes mellitus (GDM) are at risk of subsequent type 2 diabetes and adverse cardiovascular events. Digital and telemedicine interventions targeting weight loss and reductions in body mass index (BMI) may help reduce risk for women with GDM. The aim was to compare the effectiveness of digital or telemedicine intervention with usual care. Randomized controlled trials (RCTs) were identified in Embase, Medline, CINAHL, PsycINFO and the Cochrane Library. Included trials recruited women with prior GDM but without pre-existing diabetes, and tested a digital or telemedicine intervention with or without an in-person component. Data extraction was carried out independently by two authors. The search yielded 898 citations. Eighteen articles reporting 15 trials were included, of which 8 tested digital interventions. Reported outcomes included weight, BMI, fasting plasma glucose and waist circumference. None of the included trials reported type 2 diabetes incidence or cardiovascular risk. Data were pooled using a random-effects model. The point estimate favored the intervention but was non-significant for both BMI (−0.90 kg/m2, 95% CI −1.89 to 0.09; p=0.08) and weight (−1.83 kg, 95% CI −4.08 to 0.42, p=0.11). Trials evaluating digital and telemedicine interventions identified clinically relevant, but non-significant improvements in BMI and weight compared with control. No trials assessed type 2 diabetes occurrence as an outcome. More well-designed RCTs with adequate power and long-term follow-up are needed to identify the impact of these interventions on type 2 diabetes occurrence.https://drc.bmj.com/content/9/1/e002077.full |
| spellingShingle | Nia Roberts Andrew J Farmer Julia Halligan Maxine E Whelan Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions BMJ Open Diabetes Research & Care |
| title | Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions |
| title_full | Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions |
| title_fullStr | Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions |
| title_full_unstemmed | Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions |
| title_short | Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions |
| title_sort | reducing weight and bmi following gestational diabetes a systematic review and meta analysis of digital and telemedicine interventions |
| url | https://drc.bmj.com/content/9/1/e002077.full |
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