Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes

ObjectiveTo study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methodsA cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.ResultsNinety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), 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) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.ConclusionsMotivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.Trial registration numberNCT02883127.

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Maternal and fetal genetic contribution to gestational weight gain

10.1101/116434 ◽

2017 ◽

Author(s):

Nicole M Warrington ◽

Rebecca Richmond ◽

Bjarke Fenstra ◽

Ronny Myhre ◽

Romy Gaillard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Gestational Weight Gain ◽

Genetic Variants ◽

Genetic Contribution ◽

Gestational Weight ◽

Genome Wide ◽

Common Genetic Variants ◽

Maternal Bmi

AbstractBackgroundClinical recommendations to limit gestational weight gain (GWG) imply high GWG is causally related to adverse outcomes in mother or offspring, but GWG is the sum of several inter-related complex phenotypes (maternal fat deposition and vascular expansion, placenta, amniotic fluid and fetal growth). Understanding the genetic contribution to GWG could help clarify the potential effect of its different components on maternal and offspring health. Here we explore the genetic contribution to total, early and late GWG.Participants and MethodsA genome-wide association study was used to identify maternal and fetal variants contributing to GWG in up to 10,543 mothers and up to 16,317 offspring of European origin, with replication in 10,660 mothers and 7,561 offspring. Additional analyses determined the proportion of variability in GWG from maternal and fetal common genetic variants and the overlap of established genome-wide significant variants for phenotypes relevant to GWG (e.g. maternal BMI and glucose, birthweight).ResultsWe found that approximately 20% of the variability in GWG was tagged by common maternal genetic variants, and that the fetal genome made a surprisingly minor contribution to explaining variation in GWG. We were unable to identify any genetic variants that reached genome-wide levels of significance (P<5×10−8) and replicated. Some established maternal variants associated with increased BMI, fasting glucose and type 2 diabetes were associated with lower early, and higher later GWG. Maternal variants related to higher systolic blood pressure were related to lower late GWG. Established maternal and fetal birthweight variants were largely unrelated to GWG.ConclusionWe found a modest contribution of maternal common variants to GWG and some overlap of maternal BMI, glucose and type 2 diabetes variants with GWG. These findings suggest that associations between GWG and later offspring/maternal outcomes may be due to the relationship of maternal BMI and diabetes with GWG.

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Gestational weight gain and incident type 2 diabetes in the daughter

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.10.833 ◽

2006 ◽

Vol 195 (6) ◽

pp. S228

Author(s):

Alison Stuebe ◽

Karin Michels

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Gestational Weight Gain ◽

Incident Type ◽

Gestational Weight ◽

Incident Type 2 Diabetes

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Rate of Gestational Weight Gain and Glucose-Insulin Metabolism Among Hispanic Pregnant Women With Overweight and Obesity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab655 ◽

2021 ◽

Author(s):

Karen L Lindsay ◽

Lauren E Gyllenhammer ◽

Sonja Entringer ◽

Pathik D Wadhwa

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Beta Cell ◽

Pregnant Women ◽

Overweight And Obesity ◽

Sensitivity Index ◽

Cross Sectional ◽

Insulin Metabolism ◽

Gestational Weight

Abstract Context Hispanic women are at elevated risk of gestational glucose intolerance and postpartum type 2 diabetes compared with non-Hispanic White women. Identification of potentially modifiable factors contributing to this trajectory of beta-cell dysfunction is warranted. Objective We aimed to determine the association between rate of gestational weight gain (rGWG) and glucose-insulin metabolism in Hispanic pregnant women with overweight and obesity. Methods This cross-sectional, observational study, conducted from 2018-2020 at the clinical research center at University of California, Irvine, included 33 nondiabetic Hispanic pregnant women at 28 to 30 weeks’ gestation with pre-pregnancy body mass index (BMI) 25.0 to 34.9 kg/m2. Participants consumed a standardized liquid mixed meal after an overnight fast. Serial blood samples were collected at fasting and up to 2 hours postprandial. The glucose and insulin area under the curve (AUC), insulin sensitivity index (ISI) and insulin secretion sensitivity index (ISSI)-2 were computed. Results Average rGWG (0.36 ± 0.22 kg/week) was classified as excessive in 60% of women. While rGWG was not associated with the glucose or insulin AUC or ISI, it accounted for 13.4% of the variance in ISSI-2 after controlling for covariates (maternal age, parity, and pre-pregnancy BMI); for each 1 unit increase in rGWG, ISSI-2 decreased 2.1 units (P = 0.015). Conclusion Even in the absence of gestational diabetes, rGWG was inversely associated with beta-cell function in a high-risk population of Hispanic pregnant women with overweight and obesity. Beta-cell decline is an established risk factor for transition to type 2 diabetes, and these cross-sectional findings highlight rGWG as a potentially modifiable contributor to this process.

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The Effect of Gestational Weight Gain on Neonatal Birth Weight in Obese Women With Type 2 Diabetes [38P]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000558922.10997.6c ◽

2019 ◽

Vol 133 (1) ◽

pp. 180S-180S

Author(s):

Julia Kabacka ◽

D. Yvette LaCoursiere ◽

Louise Laurent ◽

Gladys Ramos

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Obese Women ◽

Gestational Weight ◽

Neonatal Birth Weight

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Adolphe Quetelet’s Premonition Two Centuries after: Besides Its Implications in Physiology (Obesity, Type 2 Diabetes), Its Paramount Importance in Human Pregnancy

Journal of Diabetes Metabolism and its Complications ◽

10.31487/j.jdmc.2020.01.05 ◽

2020 ◽

pp. 1-3

Author(s):

Pierre-Yves Robillard ◽

Pierre-Yves Robillard

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Medical Science ◽

Historical Overview ◽

Gestational Weight ◽

In Pregnancy ◽

Quetelet Index

Adolphe Quételet (1796-1874) proposed in 1835 the “Quételet index”, which was re-discovered in 1972 by Keys et al. under the acronym “Body Mass index”, BMI. The author makes an historical overview of the evolution of this BMI and its interest in medical science and anthropometry. Nowadays this BMI appears to be involved in a mathematical linear law concerning the gestational weight gain in human pregnancies. Getting rid of the current fuzzy recommendations concerning the optimal weight gain for each woman in pregnancy, this may have paramount consequences for the future. When confirmed, Quételet’s proposal will appear as a further Copernician revolution in human anthropometry.

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