Effectiveness of the National Diabetes Prevention Program After Gestational Diabetes.
Effectiveness of the National Diabetes Prevention Program After Gestational Diabetes.
复制标题
妊娠糖尿病后国家糖尿病预防计划的有效性。
DOI：
10.1016/j.amepre.2023.03.006
复制
发表时间：
2023
影响因子：
5.5
通讯作者：
Levkoff,SueE
中科院分区：
文献类型：
--
作者：
Ritchie,NatalieD;Seely,EllenW;Nicklas,JacindaM;Levkoff,SueE
前言有妊娠期糖尿病史的妇女患2型糖尿病的风险很高。国家糖尿病预防计划(NDPP)是一项广泛传播的生活方式干预措施，旨在预防2型糖尿病。尽管NDPP项目对任何年龄的成年人开放，但参与者通常是老年人。有妊娠期糖尿病的年轻女性的有效性在很大程度上尚不清楚。方法由联邦合格健康中心的大型网络中的生活方式教练提供NDPP。对40岁有妊娠期糖尿病的女性和所有其他参与者的伸展、保持、体力活动和体重减轻结果进行了比较。2013年至2019年收集数据，并于2022年进行分析。结果在同意启动为期一年的NDPP的2865名参与者中，63.3%是拉丁裔，18.8%是非拉丁裔黑人，16.4%是非拉丁裔白人。有妊娠期糖尿病的年轻女性占受试者的4%(n=107)。这些妇女参加≥1NDPP会议的频率与所有其他参与者之间没有显著差异(37.4%对44.6%；p=0.146)。然而，在参加≥1疗程(n=1,265)的患者中，在协变量调整模型中，有妊娠期糖尿病的年轻女性参加的次数更多(11.27±1.27vs8.50±0.22，p=0.021)，体重减轻(3.04%±0.59vs.1.49%±0.11，p=0.010)。因此，对这些高危人群来说，NDPP似乎是一种有益但未得到充分利用的资源。
IntroductionWomen with previous gestational diabetes are at high risk of developing Type 2 diabetes. The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention to prevent Type 2 diabetes. Although NDPP programs are open to adults of any age, participants are usually older adults. Effectiveness among younger women with previous gestational diabetes is largely unknown.MethodsThe NDPP was delivered by lifestyle coaches in a large network of Federally Qualified Health Centers. Reach, retention, physical activity, and weight loss outcomes were compared between women aged <40 years with previous gestational diabetes and all other participants. Data were collected from 2013 to 2019 and analyzed in 2022.ResultsAmong 2,865 enrollees who agreed to start the yearlong NDPP, 63.3% were Latinx, 18.8% were non-Latinx Black, and 16.4% were non-Latinx White. Younger women with previous gestational diabetes represented <4% (n=107) of participants. There was no significant difference in the frequency of attending ≥1 NDPP session between these women and all other participants (37.4% vs 44.6%;p=0.146). However, among those attending ≥1 session (n=1,265), younger women with previous gestational diabetes attended more (11.27 ± 1.27 vs 8.50 ± 0.22 sessions,p=0.021) and had greater weight loss (3.04% ± 0.59 vs. 1.49% ± 0.11,p=0.010) in covariate-adjusted models than other participants.ConclusionsDiverse younger women with previous gestational diabetes attending the NDPP had one third greater attendance and twice as much weight loss as other NDPP participants but represented a much smaller proportion of enrollees. Thus, the NDPP appears to be a beneficial but underutilized resource for this high-risk population.