Lifestyle Interventions for Pregnant T2D Patients

Researchers for a new study evaluated the effect of lifestyle coaching and motivational interviewing to improve healthy eating adherence on gestational weight gain and fetal growth in pregnant type 2 diabetes (T2D) patients. The study consisted of a cohort of pregnant women with T2D between August 2015 and February 2018 (n = 97) as well as a historical comparison cohort (n = 92) between February 2013 and August 2015. Both groups received routine care, and the intervention cohort also received motivational interviewing to improve healthy eating adherence. The primary outcome measures were gestational weight gain and large for gestational age infants. The intervention and reference groups had similar pre-pregnancy body mass index (32.8±6.9 kg/m2 vs. 32.4±7.4 kg/m2, P=0.70) and gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, P=0.25), as well as rates of HbA1c in early pregnancy (6.7%±1.1% vs. 6.5%±1.3% [50±12 mmol/mol vs 48±14 mmol/mol], P=0.32) and late pregnancy (5.9%±0.5% vs. 6.0%±0.6% [41±6 mmol/mol vs. 42±7 mmol/mol], P=0.34). The intervention group had a lower rate of large for gestational age infants (20% vs. 31%, P=0.07); the difference remained in adjusted analyses (14% vs. 27%, respectively; P=0.04). The intervention group also had a lower birth weight z-score (0.24±1.36 vs. 0.61±1.38, P=0.06). The study authors concluded that motivational interviewing, in conjunction with routine care, was effective in helping pregnant women with T2D adhere to healthy eating and reducing fetal overgrowth and did not significantly impact gestational weight gain. They also called for future studies to determine the cost-effectiveness of such interventions.