Evidence mapPaperPMID 39980013Full record

ArticleDiabetology & metabolic syndrome2025

Lifestyle intervention to prevent type 2 diabetes after a pregnancy complicated by gestational diabetes mellitus: a systematic review and meta-analysis update.

Paula Andreghetto Bracco, Angela Jacob Reichelt, Luísia Feichas Alves, Pedro Rodrigues Vidor, Maria Lúcia Rocha Oppermann, Bruce Bartholow Duncan, Maria Inês Schmidt

Abstract read
In one paragraph

Article in Diabetology & metabolic syndrome, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Diabetes and women's health.Journal of diabetes investigation · 2025
    Review
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Paula Andreghetto BraccoStatistics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0001-6899-7386
Angela Jacob ReicheltEndocrinology and Metabolism Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. areichelt@hcpa.edu.br.ORCID http://orcid.org/0000-0002-9393-3445
Luísia Feichas AlvesCentral Library, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-8400-6148
Pedro Rodrigues VidorSchool of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0001-9208-7323
Maria Lúcia Rocha OppermannDepartment of Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-6578-995X
Bruce Bartholow DuncanPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-7491-2630
Maria Inês SchmidtPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-3837-0731

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen with prior gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes, and lifestyle intervention (LSI) offered a decade after pregnancy is effective in preventing diabetes. However, since diabetes frequently onsets in the initial years following pregnancy, preventive actions should be implemented closer to pregnancy. We aimed to assess the effect of lifestyle interventions, compared to standard care, in reducing the incidence of diabetes following a pregnancy complicated by GDM.

methodsWe searched the Cochrane Library, Embase, MEDLINE, and Web of Science from inception to July 21, 2024, to identify randomized controlled trials (RCTs) testing LSI to prevent diabetes following gestational diabetes. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We evaluated the risk of bias with the Cochrane Collaboration Risk of Bias tool RoB-2 and the certainty of the evidence with GRADE methodology. We used the DerSimonian-Laird random effects pooling method and evaluated heterogeneity with the I

resultsWe identified 24 studies involving 9017 women. In studies without high risk of bias (18 studies; 8,357 women), LSI reduced the incidence of diabetes by 19% (RR = 0.81; 95%CI 0.71.0.93). The effect was significant and more protective (RR = 0.78; 0.65, 0.94) in studies evaluating women with GDM identified specifically as at a higher risk of diabetes, compared to those intervening on women with GDM irrespective of risk (RR = 0.85; 0.70, 1.04). Similarly, when expressed in absolute terms, the overall number needed to treat (NNT) was 56 considering all studies, 71 for women with GDM irrespective of risk, and 31 for women with GDM at high risk. The intervention produced a lower weight gain (mean difference=-0.88 kg;-1.52, -0.23 for all studies; -0.62 kg;-1.22, -0.02 for studies without high risk of bias). The effects were robust in sensitivity analyses and supported by evidence of moderate certainty for diabetes and weight change.

conclusionsLSI offered to women with GDM following pregnancy is effective in preventing type 2 diabetes, despite the small postpartum weight change. The impact of LSI on incidence reduction was greater for women with GDM at a higher diabetes risk. PROSPERO: Registration number CRD42024555086, Jun 28, 2024.

Indexed as

Diabetes mellitusGestational diabetesLifestyleMeta-analysis

Identifiers

PMID39980013
PMCPMC11844165

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.