Prevention of Diabetes Mellitus Type 2 in Women Post Gestational Diabetes Mellitus Diagnosis
Condition: Gestational Diabetes Mellitus
MeSH terms: Diabetes, Gestational; Diabetes Mellitus
Study type: Interventional

Summary: 
      Diabetes Mellitus (DM) is a chronic metabolic disorder with increasing incidence and long
      term complications. Its incidence differs in various ethnic populations.Gestational DM (GDM)
      is diagnosed when impaired glucose tolerance (IGT) is first detected during pregnancy. GDM
      incidence in Jewish and Bedouin women has been rising in recent years. It has been reported
      in many studies that women who had been diagnosed with GDM are more prone to GDM in their
      next pregnancies and to DM Type 2.

      Appropriate changes in everyday diet and physical exercise may reduce the chances for future
      GDM and type 2 DM.

      The investigators aim was to determine GDM frequency in the Negev area in Jewish and Bedouin
      populations and to construct a plan for follow up and reduce future problems by changing
      their life style.
    

Detailed description: 
      Diabetes Mellitus is a very common chronic metabolic disorder,currently an epidemic with
      correlation to obesity. DM frequency differs as a function of population characteristics
      factors. In Israel it is more prevalent in Jews than in Bedouins. However, lately, there has
      been a rise in DM frequency in the Bedouin population. This rise is probably due to the
      change in life style from the traditional way of life towards a western one, characterized by
      change in food habits and decrease in physical activity. This combination may lead to
      increased body mass index (BMI)and to DM.

      Many studies report higher incidence of DM type 2 following Gestational Diabetes Mellitus
      (GDM). GDM is defined as glucose intolerance which is detected during pregnancy in healthy
      women. Its frequency varies between 1 to 14% in pregnant women in different populations.
      Although usually glucose intolerance disappears after delivery,many of these women may
      develop future GMD or DM type 2. This can be delayed or even prevented by appropriate diet
      and increased physical activity.

      The aim of our study was:

        1. To determine GDM frequency in Jewish and Bedouin populations in the Negev area in
           southern Israel.

        2. To approach Jewish and Bedouin GDM women before discharge from the hospital and invite
           them to join the study and divide them into intervention group and control respectively.

        3. To study whether intervention in life style leads to similar results in both
           populations.

        4. To propose a model for predicting persistent lifestyle change intervention.

      The study included 180 women diagnosed with GDM ,133 Jewish and 47 Bedouin women.The women
      were divided in two groups, an intervention group (77 Jewish and 26 Bedouin) and control ones
      (56 Jewish and 21 Bedouin women). At their first visit, 3 months after delivery all women
      filled forms about demographic data, nutrition and physical habits. All of them, including
      the control group were given full information about GDM and increased risk for DM.

      All the women signed their informed consent forms for participation in the study. The
      intervention group had several group meetings every several months. Metabolic parameters were
      determined, including plasma insulin ,glucose and lipids levels.Height, weight, BMI, blood
      pressure and abdominal circumference were measured too. The same parameters were determined
      one and two years post partum. The intervention group had several group meetings every
      several months with a dietician and a physical exercise instructor.
    

Intervention name(s): Lifestyle instruction for Jews and Bedouin GDM women.
Intervention type(s): Behavioral
Intervention description(s): Every several months the women had instructions and checkups.
Other intervention name(s): Jew and Bedouin women with recent GDM in the Negev area.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Diabetes Mellitus Type 2; Gestational Diabetes Mellitus; Glucose Intolerance; Physical exercise; Nutritional Habits; Dyslipidemia