Nonpharmacological interventions to prevent type 2 diabetes in women diagnosed with gestational diabetes mellitus: a systematic overview
Nonpharmacological interventions to prevent type 2 diabetes in women diagnosed with gestational diabetes mellitus: a systematic overview
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DOI：
10.1007/s13340-017-0316-0
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发表时间：
2017-03
影响因子：
2.2
通讯作者：
Celine Miyazaki;Kanako Tanase-Nakao;N. Arata;R. Mori;M. Kawasaki;E. Ota
中科院分区：
文献类型：
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作者：
Celine Miyazaki;Kanako Tanase-Nakao;N. Arata;R. Mori;M. Kawasaki;E. Ota
本系统综述总结了来自多个系统综述的有关非药物干预预防妊娠期糖尿病（GDM）妇女2型糖尿病（T2MD）益处的相关证据。2015年11月18日完成了Cochrane Library、CINAHL、EMBASE和MEDLINE（通过Ovid SP）以及PubMed数据库的综合检索。任何评价随机对照试验（rct）的系统评价，均采用明确的非药物干预措施预防确诊为GDM的女性的2型糖尿病，均符合纳入标准。作者使用AMSTAR工具独立地对纳入的综述进行了关键评价和质量评估，并将提取的数据转换为一致的值，用于表格汇总。确定了六项符合条件的饮食和/或运动、母乳喂养和提醒干预；然而，评价的方法差异很大，大多数证据表明存在不明确的偏见。我们发现关于饮食和运动干预降低T2DM进展风险的比率的报道不一致，但这些干预被发现在降低血糖负荷方面有效。饮食、运动和母乳喂养相结合的干预被证明是有效的，可以使妇女恢复到产后体重。无论是单纯的饮食还是单纯的运动都不能有效地降低2型糖尿病的风险。总的来说，没有强有力的证据支持非药物干预可以有效降低诊断为GDM的女性患T2DM的风险的假设，也没有一致的证据表明这些干预可以改善T2DM的预测结果，如血糖负荷或人体测量变化。
This systematic overview summarizes the relevant evidence from multiple systematic reviews of the benefits of nonpharmacological interventions for preventing type 2 diabetes mellitus (T2MD) in women diagnosed with gestational diabetes mellitus (GDM). A comprehensive search using the Cochrane Library, CINAHL, EMBASE and MEDLINE via Ovid SP, and PubMed databases was completed on 18 November 2015. Any systematic reviews that evaluated randomized controlled trials (RCTs) with defined nonpharmacological interventions for preventing T2DM in women diagnosed with GDM were eligible for inclusion. The authors independently performed critical appraisals and quality assessments of the included reviews using the AMSTAR tool, and extracted data were converted to coherent values for tabular summarization. Six eligible reviews of diet and/or exercise, breastfeeding, and reminder interventions were identified; however, the methodologies of the reviews varied greatly, and the majority of the evidence suggested unclear bias. We found inconsistent reporting on the rates at which diet and exercise interventions reduced the risk of T2DM progression, but these interventions were found to be effective at reducing glycemic load. Combined diet, exercise, and breastfeeding interventions proved to be effective at returning women to their postpartum weight. Neither diet alone nor exercise alone proved to be effective at lowering the risk of T2DM. Overall, there was no robust evidence to support the hypothesis that nonpharmacological interventions are effective at lowering the risk of T2DM in women diagnosed with GDM, and there was no consistent evidence showing that these interventions improved the predictor outcomes of T2DM, such as glycemic load or anthropometric changes.