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Lifestyle and glycemic health 5 years postpartum in obese and non-obese high diabetes risk women.

Authors
  • Huvinen, Emilia1
  • Engberg, Elina2, 3
  • Meinilä, Jelena4, 5
  • Tammelin, Tuija6
  • Kulmala, Janne6
  • Heinonen, Kati7
  • Bergman, Paula8
  • Stach-Lempinen, Beata9
  • Koivusalo, Saila4
  • 1 Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, PL 140, 00029 HUS, Helsinki, Finland. [email protected] , (Finland)
  • 2 Folkhälsan Research Center, Helsinki, Finland. , (Finland)
  • 3 Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland. , (Finland)
  • 4 Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, PL 140, 00029 HUS, Helsinki, Finland. , (Finland)
  • 5 Department of Food and Nutrition, University of Helsinki, Helsinki, Finland. , (Finland)
  • 6 LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland. , (Finland)
  • 7 Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland. , (Finland)
  • 8 Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. , (Finland)
  • 9 Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland. , (Finland)
Type
Published Article
Journal
Acta diabetologica
Publication Date
Dec 01, 2020
Volume
57
Issue
12
Pages
1453–1462
Identifiers
DOI: 10.1007/s00592-020-01553-1
PMID: 32712801
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Women with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI. The RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI ≥ 30 kg/m2 and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m2. Altogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c. Lifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women. ClinicalTrials.gov, http://www.clinicaltrials.com , NCT01698385.

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