Effectiveness of the National Diabetes Prevention Program After Gestational Diabetes

Introduction: Women with previous gestational diabetes are at high risk of developing Type 2 diabetes. The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention to prevent Type 2 diabetes. Although NDPP programs are open to adults of any age, participants are usually older adults. Effectiveness among younger women with previous gestational diabetes 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 aged <40 years with previous gestational diabetes and all other participants. Data were collected from 2013 to 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 previous gestational diabetes represented <4% (n=107) of participants. There was no significant difference in the frequency of attending & GE;1 NDPP session between these women and all other participants (37.4% vs 44.6%; p=0.146). However, among those attending & GE;1 session (n=1,265), younger women with previous gestational diabetes attended more (11.27 & PLUSMN; 1.27 vs 8.50 & PLUSMN; 0.22 sessions, p=0.021) and had greater weight loss (3.04% & PLUSMN; 0.59 vs. 1.49% & PLUSMN; 0.11, p=0.010) in covariate-adjusted models than other participants. Conclusions: Diverse younger women with previous gestational diabetes 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. Am J Prev Med 2023;65(2):317-321. & COPY; 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.