A randomised controlled trial of a psychosocial weight-management programme in overweight or obese pregnant women improved diet and activity but not gestational diabetes, preeclampsia, or caesarean rates. PICO summary and expert commentary.
A secondary analysis of a 6-month randomized trial found that higher baseline weight-loss self-efficacy predicted at least 5% weight loss in both diet arms, with BMI and age as arm-specific predictors. PICO summary and expert commentary.
The DPPOS demonstrated that cumulative diabetes prevention from the DPP lifestyle intervention and metformin persists over 10 years from original randomisation, with 34% and 18% reductions in cumulative diabetes incidence despite post-DPP convergence of care, establishing a diabetes prevention legacy effect and confirming the durability of early preventive intervention.
The DREAM trial demonstrated that rosiglitazone reduces incident diabetes or death by 60% and achieves normoglycaemia in 50% of high-risk adults with impaired glucose tolerance, the largest pharmacological diabetes prevention effect documented in a large RCT, but the drug's subsequent cardiovascular safety concerns and market withdrawal have prevented translation of these findings into clinical practice.
The Diabetes Prevention Program demonstrated that intensive lifestyle intervention reduces type 2 diabetes incidence by 58% with a NNT of 6.9 over 2.8 years in high-risk adults, outperforming metformin which reduced incidence by 31%, establishing structured lifestyle modification as the primary preventive strategy for pre-diabetes and the evidence base for national prevention programmes.
A double-blind RCT finds vitamin D improves insulin secretion and HOMA-IR but not fasting glucose in women with prediabetes. PICO summary and clinical expert commentary.
An RCT finds a short metformin course after antenatal betamethasone lowers maternal glucose and halves neonatal hypoglycaemia. PICO summary and expert commentary for clinicians.
A secondary analysis of the BEFORE THE BEGINNING trial finds preconception lifestyle change does not reduce macrosomia or neonatal adiposity. PICO summary and expert commentary.
A four-arm RCT finds combining training with a polyphenol supplement improves prediabetes markers most, with exercise the main driver. PICO summary and expert commentary.
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