Assessing the Role of Lifestyle Interventions in Managing Gestational Diabetes Mellitus (GDM)

Abstract

Objective: To evaluate the effectiveness of Intensive Lifestyle Intervention (ILI) compared to Standard Care
(SC) in achieving glycemic control among women diagnosed with Class A1 gestational diabetes mellitus
(GDM).
Background: Gestational Diabetes Mellitus (GDM) is one of the most prevalent metabolic disorders during
pregnancy, linked to increased maternal and neonatal complications as well as long-term cardiometabolic
risks. While lifestyle modification is the first-line therapy, evidence on intensive structured interventions
versus standard care remains limited, particularly in resource limited settings. The study was conducted at Dr
Najma Ghaffar Hospital and Research Institute Quetta, Balochistan over a period of two year from January
2024 to December 2025.
Methodology: A randomized controlled trial was conducted involving pregnant women aged 20–45 years
diagnosed with GDM according to the IADPSG criteria. The screening was conducted on all pregnant
antenatal patients at 16 weeks of gestation. Participants in the ILI group received structured dietary support, a
moderate-intensity exercise program, and regular follow-up, while the (SC) group received routine obstetric
care.
Results: A total of 120 women with gestational diabetes mellitus were randomized equally into the Intensive
Lifestyle Intervention (ILI) and SC groups (n=60 each). Significantly more women in the ILI group achieved
target fasting blood glucose levels (<95 mg/dL) compared with the SC group (69% vs. 30%, p<0.001).
Similarly, optimal glycemic control (HbA1c <5.8%) was achieved by 66% of participants in the ILI group
compared with 28% in the SC group (p<0.001). The requirement for pharmacologic therapy was significantly
lower in the ILI group than in the SC group (27% vs. 70%, p<0.001). Furthermore, mean gestational weight
gain was significantly reduced among women receiving ILI (7.0 ± 1.5 kg) compared with those receiving
standard care (10.2 ± 2.1 kg; p<0.001).
Conclusion: Overall, the findings underscore the efficacy of intensive lifestyle interventions combining
tailored nutrition, regular physical activity, and continuous clinical monitoring in achieving glycemic control,
minimizing pharmacologic dependence, and improving maternal health outcomes in women with GDM.