TY - JOUR
T1 - Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine
T2 - a systematic review and meta-analysis
AU - Lim, Siew S.
AU - Takele, Wubet Worku
AU - Vesco, Kimberly K.
AU - Redman, Leanne M.
AU - Hannah, Wesley
AU - Bonham, Maxine P.
AU - Chen, Mingling
AU - Chivers, Sian C.
AU - Fawcett, Andrea J.
AU - Grieger, Jessica A.
AU - Habibi, Nahal
AU - Leung, Gloria K.W.
AU - Liu, Kai
AU - Mekonnen, Eskedar Getie
AU - Pathirana, Maleesa
AU - Quinteros, Alejandra
AU - Taylor, Rachael
AU - Ukke, Gebresilasea G.
AU - Zhou, Shao J.
AU - ADA/EASD PMDI
A2 - Vilsbøll, Tina
A2 - Loos, Ruth J.F.
A2 - Nakabuye, Mariam
A2 - Hansen, Torben
A2 - Guasch-Ferré, Marta
A2 - Clemmensen, Christoffer
A2 - Andersen, Mette K.
A2 - Thuesen, Anne Cathrine B.
A2 - Merino, Jordi
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.
AB - Background: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods: We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results: From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions: GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.
U2 - 10.1038/s43856-023-00366-x
DO - 10.1038/s43856-023-00366-x
M3 - Journal article
C2 - 37794119
AN - SCOPUS:85173449756
VL - 3
JO - Communications Medicine
JF - Communications Medicine
SN - 2730-664X
IS - 1
M1 - 137
ER -