Objective:To systematically evaluate the effect of lifestyle intervention on the development of postpartum type 2 diabetes mellitus(T2DM) in pregnant women with gestational diabetes.Methods:The randomized controlled trials(RCTs) of lifestyle intervention on the development of postpartum T2DM in pregnant women with gestational diabetes were retrieved from PubMed,EMBASE,CINAHL,the Cochrane Library,Web of Science,CNKI,WangFang,VIP,and the Chinese biomedical literature database (CBM).The Revman5.3 software was used to statistically analyze the data.Results:A total of 15 pieces of literatures were included in this study.The meta-analysis results showed that compared with the conventional nursing measures,lifestyle interventions could decrease gestational diabetes maternal postpartum weight[SMD=-0.37,95 ％ CI(-0.53,-0.21),P＜0.01],BMI [SMD=-0.36,95％CI(-0.52,-0.20),P＜0.01],waist circumference[SMD=-0.19,95％CI(-0.32,-0.06),P＜0.01],while had no obvious improvement in the fasting glucose[SMD=-0.06,95％CI(-0.19,0.06),P=0.31]and OGTT of 2 h blood glucose[SMD=-0.09,95％ CI(-0.20,-0.03),P =0.15].Conclusion:The lifestyle intervention had a significant improvement in postpartum weight and BMI in patients with gestational diabetes,and further study on postpartum glucose metabolism was needed.Lifestyle interventions had a positive effect on the occurrence and development of postpartum T2DM in pregnancy,suggesting a follow-up study of large-sample and long-term follow-up.%[目的]系统评价生活方式干预对妊娠期糖尿病孕妇产后2型糖尿病(T2DM)发生发展的影响.[方法]计算机检索PubMed、EMBASE、CINAHL、Cochrane Library、Web of Science、中国知网、万方数据库、维普中文期刊数据库、中国生物医学文献数据库中关于妊娠期糖尿病产后生活方式干预的随机对照试验(RCT),使用Revman 5.3软件对数据进行统计分析.[结果]共纳入文献15篇.Meta分析结果显示:与常规护理措施相比,生活方式干预措施可降低妊娠期糖尿病孕妇产后体重[SMD=-0.37,95％CI(-0.53,-0.21),P＜0.01]、BMI[SMD=-0.36,95％CI(-0.52,-0.20),P＜0.01]、腰围[SMD=-0.19,95％CI(-0.32,-0.06),P＜0.01],对空腹血糖[SMD=-0.06,95％CI(-0.19,0.06),P=0.31]、OGTT2 h血糖[SMD=-0.09,95％CI(-0.20,-0.03),P=0.15]无明显改善作用.[结论]生活方式干预对妊娠期糖尿病产后体重、BMI具有明显的改善作用,对产后糖代谢有待进一步研究.生活方式干预措施对预防妊娠期糖尿病产后T2DM的发生发展具有积极作用,建议后续进行大样本、长时间的随访研究.
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