Introduction
Women with prior gestational diabetes (GDM) are at high risk of developing type 2
diabetes (T2D). The National Diabetes Prevention Program (NDPP) is a widely disseminated
lifestyle intervention to prevent T2D. While NDPP programs are open to adults of any
age, participants are usually older adults. Effectiveness among younger women with
prior GDM is largely unknown.
Methods
The NDPP was delivered by lifestyle coaches in a large network of Federally Qualified
Health Centers. Reach, retention, physical activity, and weight loss outcomes were
compared between women <40 years old with prior GDM and all other participants. Data
were collected from 2013-2019 and analyzed in 2022.
Results
Among 2,865 enrollees who agreed to start the yearlong NDPP, 63.3% were Latinx, 18.8%
were non-Latinx Black, and 16.4% were non-Latinx white. Younger women with prior GDM
represented <4% (n=107) of participants. There was no significant difference in the
frequency of attending ≥1 NDPP session between these women and all other participants
(37.4% vs. 44.6%; P=0.146). However, among those attending ≥1 session (n=1,265), younger
women with prior GDM attended more (11.27 ± 1.27 vs. 8.50 ± 0.22 sessions, P=0.021)
and had greater weight loss (3.04% ± 0.59 vs. 1.49% ± 0.11, P=0.010) in covariate-adjusted
models than other participants.
Conclusions
Diverse younger women with prior GDM attending the NDPP had one-third greater attendance
and twice as much weight loss as other NDPP participants, but represented a much smaller
proportion of enrollees. Thus, the NDPP appears to be a beneficial but underutilized
resource for this high-risk population.
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Copyright
© 2023 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
