THE EFFECT OF INTENSIVE LIFESTYLE INTERVENTION ON GLYCAEMIA, BODY MASS INDEX AND LIPID PROFILE IN OVERWEIGHT AND OBESE WOMEN WITH PREDIABETES AND HISTORY OF GESTATIONAL DIABETES MELLITUS

A RANDOMIZED CONTROLLED TRIAL

Abstract

INTRODUCTION
Gestational diabetes mellitus (GDM) has been associated with increased risk for future diabetes mellitus. Due to high risk of progression to Type 2 diabetes mellitus (T2DM), postpartum care is very important. Intensive lifestyle intervention with physical activity and dietary intervention has proven to reduce or prevent T2DM in the future.

METHODOLOGY
This is a randomized controlled trial involving women with prediabetes and previous GDM. 22 subjects were randomized to either intensive lifestyle intervention (ILI) or standard medical care (SMC). The study duration was 6 months. Blood parameters were taken at baseline. Patients in ILI group received consultation including dietary and exercise intervention at baseline (0 month), 3 months and 6 months with monthly phone consultation and regular session via WhatsApp and emails. Subjects in SMC were seen at baseline (0 month), 3 months and 6 months and received standard health care advice. At 6 months, all subjects’ weight were assessed and repeat blood test including OGTT, HbA1c and lipid profile were done.

RESULTS
A total of 21 subjects were included with 13 subjects in the ILI group and 8 subjects in the SMC group. One subject was excluded due to pregnancy. At baseline, all subjects in both groups had Impaired Glucose Tolerance (IGT) and Class I Obesity. Most of the baseline characteristics were the same in both groups except HDL-C and HbA1c. At 6 months, 46% of subjects in ILI group returned to euglycaemia while in SMC group, only 25% of subjects were euglycaemic. Changes in BMI and lipid parameters were not significantly different in both groups after 6 months.

CONCLUSION
Our result showed ILI resulted in higher percentage of subjects returning to euglycaemia compared to SMC. However, BMI and lipid changes were not significantly different when comparing both groups.