Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;28(8):1354-1379.
doi: 10.1007/s10995-024-03948-w. Epub 2024 Jun 3.

Preventing Type 2 Diabetes after Gestational Diabetes: A Systematic Review Mapping Physical Activity Components using the Socio-Ecological Model

Elysa Ioannou  1 , Helen Humphreys  2 , Catherine Homer  3 , Alison Purvis  3
Affiliations

Preventing Type 2 Diabetes after Gestational Diabetes: A Systematic Review Mapping Physical Activity Components using the Socio-Ecological Model

Elysa Ioannou et al. Matern Child Health J. 2024 Aug.

Abstract

Objectives: Gestational diabetes commonly occurs during pregnancy and increases lifetime risk of type 2 diabetes following pregnancy. Engaging in physical activity postnatally can reduce this subsequent risk. Interventions aiming to increase physical activity after gestational diabetes may not address the wide range of post-pregnancy barriers. A socio-ecological approach highlights the need to include multi-level factors such as social, community and organisational factors. The aim of the review was to map intervention components to prevent type 2 diabetes after gestational diabetes using the socio-ecological model as a framework and investigate how physical activity changes align with different intervention components utilised.

Methods: Eligible studies included any study type within 5 years of a gestational diabetes diagnosis and targeted physical activity. A systematic search of MEDLINE, Cochrane Library, Web of Science, CINAHL Complete, and Scopus was conducted in October 2022. Results were categorised based on whether findings demonstrated no increases, non-statistically significant increases or statistically significant increases in physical activity.

Results: Forty-eight studies were included (37 different interventions). Thirty-eight studies were assessed as "adequate" quality, only two studies were "good" quality, and the remaining were limited quality. Mixed physical activity outcomes were observed across components used at the intrapersonal level, with components across other levels of the socio-ecological model showing more increases in physical activity. Intervention components within the social and organisational levels, for example childcare provision, providing group-based sessions and offering remote delivery, were more often present in interventions with physical activity increases.

Conclusions for practice: Future interventions targeting physical activity after gestational diabetes should aim to include social and organisational-level components in their intervention design. This systematic review was registered in PROSPERO (ID: CRD42021272044).

Keywords: Exercise; Gestational Diabetes Mellitus; Physical Activity; Socio-Ecological Model; Type 2 Diabetes Mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Socio-ecological model adapted to lifestyle changes in postpartum mums with previous GDM. From: McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q 1988, 15:351–377
Fig. 2
Fig. 2
PRISMA 2020 flow diagram for systematic reviews which include searches of databases. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. https://doi.org/10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/
Fig. 3
Fig. 3
Configuration of level type by number of interventions. Key: I Intrapersonal; S social (interpersonal); O Organisational; C Community; P Policy; Y* significant PA changes; Y non-significant PA changes; N no PA changes; U unpublished
See this image and copyright information in PMC

References

    1. Athavale, P., Thomas, M., Delgadillo-Duenas, A. T., Leong, K., Najmabadi, A., Harleman, E., Rios, C., Quan, J., Soria, C., & Handley, M. A. (2016). Linking high risk postpartum women with a technology enabled health coaching program to reduce diabetes risk and improve wellbeing: Program description, case studies, and recommendations for community health coaching programs. Journal of Diabetes Research,2016, 4353956. 10.1155/2016/4353956 10.1155/2016/4353956 - DOI - PMC - PubMed
    1. Ayman, G., Strachan, J. A., McLennan, N., Malouf, R., Lowe-Zinola, J., Magdi, F., Roberts, N., Alderdice, F., Berneantu, I., Breslin, N., Byrne, C., Carnell, S., Churchill, D., Grisoni, J., Hirst, J. E., Morris, A., Murphy, H. R., O’Brien, J., Schmutz, C., & Knight, M. (2021). The top ten research priorities in diabetes and pregnancy according to women, support networks and healthcare professionals. Diabetic Medicine,38(8), e14588. 10.1111/dme.14588 10.1111/dme.14588 - DOI - PMC - PubMed
    1. Bao, W., Tobias, D. K., Bowers, K., Chavarro, J., Vaag, A., Grunnet, L. G., Strøm, M., Mills, J., Liu, A., Kiely, M., & Zhang, C. (2014). Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: A prospective cohort study. JAMA Internal Medicine,174(7), 1047–1055. 10.1001/jamainternmed.2014.1795 10.1001/jamainternmed.2014.1795 - DOI - PMC - PubMed
    1. Bentley-Lewis, R., Levkoff, S., Stuebe, A., & Seely, E. W. (2008). Gestational diabetes mellitus: Postpartum opportunities for the diagnosis and prevention of type 2 diabetes mellitus. Nature Clinical Practice Endocrinology & Metabolism,4(10), 552–558. 10.1038/ncpendmet096510.1038/ncpendmet0965 - DOI - PMC - PubMed
    1. Booth, A., Sutton, A., & Papaioannou, D. (2012). Systematic approaches to a successful literature review. Journal of the Canadian Health Libraries Association/journal De L’association Des Bibliothèques De La Santé Du Canada,34(1), 009. 10.5596/c13-00910.5596/c13-009 - DOI

Publication types

LinkOut - more resources