PT  - JOURNAL ARTICLE
AU  - Julia Halligan
AU  - Maxine E Whelan
AU  - Nia Roberts
AU  - Andrew J Farmer
TI  - Reducing weight and BMI following gestational diabetes: a systematic review and meta-analysis of digital and telemedicine interventions
AID  - 10.1136/bmjdrc-2020-002077
DP  - 2021 Apr 01
TA  - BMJ Open Diabetes Research & Care
PG  - e002077
VI  - 9
IP  - 1
4099  - http://drc.bmj.com/content/9/1/e002077.short
4100  - http://drc.bmj.com/content/9/1/e002077.full
SO  - BMJ Open Diab Res Care2021 Apr 01; 9
AB  - Women with past gestational diabetes mellitus (GDM) are at risk of subsequent type 2 diabetes and adverse cardiovascular events. Digital and telemedicine interventions targeting weight loss and reductions in body mass index (BMI) may help reduce risk for women with GDM. The aim was to compare the effectiveness of digital or telemedicine intervention with usual care. Randomized controlled trials (RCTs) were identified in Embase, Medline, CINAHL, PsycINFO and the Cochrane Library. Included trials recruited women with prior GDM but without pre-existing diabetes, and tested a digital or telemedicine intervention with or without an in-person component. Data extraction was carried out independently by two authors. The search yielded 898 citations. Eighteen articles reporting 15 trials were included, of which 8 tested digital interventions. Reported outcomes included weight, BMI, fasting plasma glucose and waist circumference. None of the included trials reported type 2 diabetes incidence or cardiovascular risk. Data were pooled using a random-effects model. The point estimate favored the intervention but was non-significant for both BMI (−0.90 kg/m2, 95% CI −1.89 to 0.09; p=0.08) and weight (−1.83 kg, 95% CI −4.08 to 0.42, p=0.11). Trials evaluating digital and telemedicine interventions identified clinically relevant, but non-significant improvements in BMI and weight compared with control. No trials assessed type 2 diabetes occurrence as an outcome. More well-designed RCTs with adequate power and long-term follow-up are needed to identify the impact of these interventions on type 2 diabetes occurrence.All data relevant to the study are included in the article or uploaded as supplemental information.