Effectiveness of the National Diabetes Prevention Program after Gestational Diabetes.

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.