Postnatal lifestyle intervention for overweight women with previous gestational diabetes mellitus (PAIGE): a pilot randomised controlled trial

Obesity is a risk factor for Gestational Diabetes Mellitus (GDM) and subsequent type 2 diabetes. Lifestyle modification can prevent type 2 diabetes. Our aim was to determine the effectiveness of a postnatal lifestyle intervention for overweight women with a history of GDM. A pragmatic randomised controlled trial with two parallel arms was conducted in two metabolic‐obstetric clinics in Northern Ireland. Participants were overweight women with a history of GDM in their most recent pregnancy. The intervention included a 1 h education session with accompanying booklet based on the Diabetes Prevention Programme, delivered during the postnatal oral glucose tolerance test by a health educator using motivational interview techniques. Two individualised goals were set: 5 % weight loss over a 6 month period; 150 min of brisk physical activity each week. The intervention group received free 3 month membership to a commercial weight management organisation (Slimming World); a pedometer and structured telephone and text support. The primary outcome was weight loss at 6 months. Of the 404 women screened, 220 women met the inclusion criteria. In total, sixty women were randomised to intervention (n = 31) or usual care (control, n = 29). Weight loss data was available on 45 women (intervention, n = 20; control, n = 25). Women in the intervention group lost significantly more weight than women in the control group [mean (standard deviation) 3.8 (7.0)kg vs ‐0.7 (3.8)kg; mean difference 4.5 kg (95 % confidence intervals 0.9; 8.1), p = 0.02]. Findings suggests that this pragmatic multi‐component lifestyle intervention is effective in helping overweight women with a history of GDM to lose weight.