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Mothers after gestational diabetes in Australia (MAGDA) : a randomised controlled trial of a postnatal diabetes prevention program

O'Reilly, Sharleen L., Dunbar, James A., Versace, Vincent, Janus, Edward, Best, James D., Carter, Rob, Oats, Jeremy J. N., Skinner, Timothy, Ackland, Michael, Phillips, Paddy A., Ebeling, Peter R., Reynolds, John, Shih, Sophy T. F., Hagger, Virginia, Coates, Michael and Wildey, Carol 2016, Mothers after gestational diabetes in Australia (MAGDA) : a randomised controlled trial of a postnatal diabetes prevention program, PLoS medicine, vol. 13, no. 7, pp. 1-21, doi: 10.1371/journal.pmed.1002092.

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Title Mothers after gestational diabetes in Australia (MAGDA) : a randomised controlled trial of a postnatal diabetes prevention program
Author(s) O'Reilly, Sharleen L.ORCID iD for O'Reilly, Sharleen L. orcid.org/0000-0003-3547-6634
Dunbar, James A.ORCID iD for Dunbar, James A. orcid.org/0000-0003-0866-4365
Versace, VincentORCID iD for Versace, Vincent orcid.org/0000-0002-8514-1763
Janus, Edward
Best, James D.
Carter, RobORCID iD for Carter, Rob orcid.org/0000-0002-1586-5619
Oats, Jeremy J. N.
Skinner, Timothy
Ackland, Michael
Phillips, Paddy A.
Ebeling, Peter R.
Reynolds, John
Shih, Sophy T. F.ORCID iD for Shih, Sophy T. F. orcid.org/0000-0003-0049-2888
Hagger, Virginia
Coates, Michael
Wildey, CarolORCID iD for Wildey, Carol orcid.org/0000-0003-3007-2470
Journal name PLoS medicine
Volume number 13
Issue number 7
Start page 1
End page 21
Total pages 21
Publisher PLoS
Place of publication San Francisco, Calif.
Publication date 2016-07
ISSN 1549-1676
Keyword(s) MAGDA Study Group
Summary BACKGROUND: Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for type 2 diabetes. We evaluated the effectiveness of a group-based lifestyle modification program in mothers with prior GDM within their first postnatal year. METHODS AND FINDINGS: In this study, 573 women were randomised to either the intervention (n = 284) or usual care (n = 289). At baseline, 10% had impaired glucose tolerance and 2% impaired fasting glucose. The diabetes prevention intervention comprised one individual session, five group sessions, and two telephone sessions. Primary outcomes were changes in diabetes risk factors (weight, waist circumference, and fasting blood glucose), and secondary outcomes included achievement of lifestyle modification goals and changes in depression score and cardiovascular disease risk factors. The mean changes (intention-to-treat [ITT] analysis) over 12 mo were as follows: -0.23 kg body weight in intervention group (95% CI -0.89, 0.43) compared with +0.72 kg in usual care group (95% CI 0.09, 1.35) (change difference -0.95 kg, 95% CI -1.87, -0.04; group by treatment interaction p = 0.04); -2.24 cm waist measurement in intervention group (95% CI -3.01, -1.42) compared with -1.74 cm in usual care group (95% CI -2.52, -0.96) (change difference -0.50 cm, 95% CI -1.63, 0.63; group by treatment interaction p = 0.389); and +0.18 mmol/l fasting blood glucose in intervention group (95% CI 0.11, 0.24) compared with +0.22 mmol/l in usual care group (95% CI 0.16, 0.29) (change difference -0.05 mmol/l, 95% CI -0.14, 0.05; group by treatment interaction p = 0.331). Only 10% of women attended all sessions, 53% attended one individual and at least one group session, and 34% attended no sessions. Loss to follow-up was 27% and 21% for the intervention and control groups, respectively, primarily due to subsequent pregnancies. Study limitations include low exposure to the full intervention and glucose metabolism profiles being near normal at baseline. CONCLUSIONS: Although a 1-kg weight difference has the potential to be significant for reducing diabetes risk, the level of engagement during the first postnatal year was low. Further research is needed to improve engagement, including participant involvement in study design; it is potentially more effective to implement annual diabetes screening until women develop prediabetes before offering an intervention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000338066.
Language eng
DOI 10.1371/journal.pmed.1002092
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085176

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.