Testing strategies to prevent diabetes

GDM is a serious condition with possibly dire consequences for both mother and baby in pregnancy. Women with past GDM comprise up to around 30 % of women who present with T2D. Moreover, exposure in the womb to GDM might predispose children to diabetes and obesity in later life.

The EU-funded DALI (Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention) project is working on protecting both mothers and babies from the damage that GDM can cause. They are investigating three interventions to prevent GDM: physical activity, diet and vitamin D supplementation, either alone or in combination. Variables to be measured in the trials include maternal glucose tolerance, maternal weight gain and insulin sensitivity.

Project work so far has resulted in completion of the pilot study, and recruitment for the full trial is ongoing. DALI implemented training workshops for lifestyle coaches and nurses; 440 pregnant women completed the trial for lifestyle intervention testing, out of whom 101 developed GDM.

Vitamin D and placebo was distributed to the relevant study sites. Out of 144 women enrolled in the vitamin D intervention so far, 92 completed the trial and 28 developed GDM.

Researchers have established the DALI biobank and optimised their web-based database. Sample collection and analyses as well as data entry are ongoing.

Promotion of the project has been carried out via newspapers, a research fair and media interviews. A manuscript describing the DALI trial was published in BMC Pregnancy & Childbirth and the pilot study is in press with Diabetes Care. In addition, several free papers were presented as posters or orally at national and international meetings.

DALI is a comprehensive research programme that on completion will enhance our understanding of GDM and enable the development of effective preventative measures. DALI will also provide information on factors predisposing to GDM and its prevalence in various European populations.

Project data and the DALI biobank could form the basis for wider pan-European studies in the future. Standardising screening and GDM diagnostic tools along with the identification of GDM phenotypes could mean personalised GDM treatment in the future. Ultimately, preventing T2D onset will not only reduce patient suffering but also alleviate the immense economic burden of this disease.