Diabetes Prevention in Women With a Recent History of Gestational Diabetes Mellitus (GDM)

The landmark Diabetes Prevention Program (DPP) demonstrated that intensive lifestyle
intervention in people with impaired glucose tolerance (IGT) could reduce the incidence of
type 2 diabetes (Knowler, Barrett-Connor et al. 2002). These findings were consistent,
regardless of ethnicity, age, body mass index (BMI), gender (Knowler, Barrett-Connor et al.
2002). However, the DPP lacks a specific focus on new mothers with a recent history of
gestational diabetes despite their documented high risk for developing Type 2 diabetes.
Although there are recommendations that all women with gestational diabetes mellitus (GDM)
receive postpartum testing for diabetes and type 2 diabetes risk reduction, study findings
suggest that women with a recent history of GDM may be unaware of their risk for future
diabetes, and also do not take steps to reduce their risks (Kim et al., 2007). The
postpartum period is also a time when many changes occur in a woman's life, with competing
responsibilities often altering sleep patterns, work schedules, eating patterns, exercise
regularity, and time allocation (Walker, 1999; Swan et al., 2007). New mothers may have
difficulties engaging in healthy lifestyle programs because of lack of time and energy, and
because of competing work and family demands, including child care (Swan, Kilmartin, and
Liaw, 2007).

Modeled around the barriers identified in literature and gleaned from the focus groups and
informant interviews of the preliminary study (2009p-000042), we have created a
lifestyle/behavioral intervention that utilizes a modified DPP.