The prevalence of gestational diabetes (GDM) is increasing substantially and currently affects up to 14% of pregnancies. As many as 70% of women with GDM will develop type 2 diabetes (T2D) in the next 10 years. Moreover as many as 40% of children exposed to in-utero diabetes will develop obesity and T2D. The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention that has been shown to lower T2D risk by 58% in high-risk adults. Family based lifestyle interventions that target either children, parents or both have reported mixed results. We modified the DPP curriculum to use with families (DPPF) and recruited mothers with a history of GDM and their children 8-15 years old. We randomized n=130 families to test which method of delivering the DPPF (mothers only (M) or mothers and their children (M+C)) is more effective at lowering families T2D risk. Baseline characteristics of women were similar among each intervention group (n=65 M and n=65 M+C, respectively): age (38±8 vs 39±11, P=0.5), ethnicity (Black 55% vs 55%, White 20% vs 17%, Latino 20% vs 27%, other 5% vs 2%, P=0.6), body mass index (BMI, 37±8 vs 38±7, P=0.24), systolic blood pressure (SBP, 121±11 vs 122±13, P=0.8), diastolic blood pressure (DBP, 103±26 vs 105±21, P=0.6), HbA1c (5.6±0.4 vs 5.7±0.3, p=0.2). The majority of women self-reported low levels of physical activity (PA): moderate PA (2 days or less per week, 42% vs 26%, P=0.06) or vigorous PA (2 days or less per week, 38% vs 25%, P=0.1), and high levels of sedentary activities (3 or more hours per day, 49% vs 58%, P=0.2). For diet related obesogenic behaviors women self-reported high levels of eating meals while watching TV (3 days or more per week, 58% vs 74%, P=.06) and eating at restaurants (3 days or more per week, 28% vs 41%, P=0.1). Follow-up is ongoing and currently n=32 families have completed the 3-month follow-up. Preliminary analyses of mothers show decreases in HbA1c (-.01±.3 vs -.1±.2), SBP (-9.7±30 vs -3.1±8), DBP (-8±19 vs -1±9) but not BMI (0.07±1.6 vs 0.04±1.2); however results were not significantly different by intervention group.
Genetic ancestry markers and difference in A1c between African-American and White in the Diabetes Prevention Program