Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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Open-label or unblinded (moderate): Open-label design

Change difference −0.95 kg, 95% CI −1.87 to −0.04; p=0.04. Intervention −0.23 kg vs usual care +0.72 kg

Intervention group maintained weight (−0.23 kg, 95% CI −0.89 to 0.43) while usual care gained weight (+0.72 kg, 95% CI 0.09 to 1.35). The between-group difference was −0.95 kg (95% CI −1.87 to −0.04, p=0.04), representing prevention of weight gain rather than weight loss.

Change difference −0.50 cm, 95% CI −1.63 to 0.63; p=0.389. Intervention −2.24 cm vs control −1.74 cm

Waist circumference decreased in both groups with no significant between-group difference: −2.24 cm in intervention vs −1.74 cm in control (change difference −0.50 cm, 95% CI −1.63 to 0.63, p=0.389).

Change difference −0.05 mmol/L, 95% CI −0.14 to 0.05; p=0.331. Intervention +0.18 vs control +0.22 mmol/L

Fasting blood glucose increased slightly in both groups with no significant difference: +0.18 mmol/L in intervention vs +0.22 mmol/L in control (change difference −0.05 mmol/L, 95% CI −0.14 to 0.05, p=0.331). Glucose profiles were near normal at baseline.

Depression score was listed as a secondary outcome. Specific results for depression are not available from the provided excerpts. The specific questionnaire used is not confirmed from the excerpts.

The MAGDA-DPP programme is a group-based lifestyle modification programme tailored for women with prior GDM. It includes individual, group, and telephone support sessions focusing on diet, physical activity, and weight management for diabetes prevention. Most participants had normal glucose metabolism at baseline (only 10% IGT, 2% IFG), so the 'prediabetes' label is imprecise but the intervention content (lifestyle modification for diabetes prevention) closely matches the reference class.

Positive: 1; Negative: 0; No effect: 2; Mixed: 0

Extracted 4 outcome signals across the study

One primary outcome (weight) was statistically significant in a positive direction, while two primary outcomes (waist circumference, fasting glucose) showed no significant difference. Secondary outcomes are not fully reported in excerpts.

↓ Weight gain prevented: intervention group stable vs usual care +0.72 kg (difference −0.95 kg, p=0.04)

↔ Waist circumference: no significant difference between groups

Mostly intermediate or surrogate outcomes

The MAGDA lifestyle programme prevented postnatal weight gain in women with prior GDM, but did not improve other diabetes risk factors

Engagement was very low: only 10% attended all sessions, and 34% attended none

Loss to follow-up was high (27% intervention, 21% control), mainly due to subsequent pregnancies

O'Reilly SL, Dunbar JA, Versace V, et al. Mothers after Gestational Diabetes in Australia (MAGDA): a randomised controlled trial of a postnatal diabetes prevention program. PLOS Med. 2016;13(7):e1002092. doi:10.1371/journal.pmed.1002092

Low programme engagement: only 10% completed all sessions

High attrition: 27% loss to follow-up in intervention group

Baseline glucose profiles were near normal, limiting ability to detect changes

Primary outcome (weight) significant but other primary outcomes (waist, glucose) non-significant

A group-based lifestyle programme helped women with prior gestational diabetes avoid weight gain in the first year after giving birth, but engagement was low with only 10% attending all sessions.

↔ Fasting blood glucose: no significant difference between groups

One individual session (60-90 min), five group sessions (90 min each), and two telephone sessions (15-20 min). Only 10% attended all sessions, 53% attended one individual + at least one group, 34% attended none.

MAGDA-DPP lifestyle modification programme

Usual care

High dropout rate (moderate): 27% dropout

Includes self-reported outcomes (moderate): Self-reported outcomes used

Limited population scope (moderate): Narrow population scope

Limited safety reporting (moderate): Safety reporting depth: not_reported

Postnatal lifestyle programme prevents weight gain after gestational diabetes

This study tested a lifestyle programme for new mothers who had gestational diabetes, to help prevent later type 2 diabetes. Women in the programme maintained their weight while those receiving usual care gained weight over 12 months. However, most women did not fully participate in the programme, and there were no clear improvements in waist size or blood sugar.

The programme prevented weight gain but did not lead to weight loss — the benefit was mainly avoiding the weight gain seen in usual care

Low attendance and high dropout make it hard to know if the programme could work better for women who are able to fully participate

The first year after childbirth is a challenging time for lifestyle interventions, as many women became pregnant again during the study

Effectiveness of a postnatal lifestyle modification programme in women with prior GDM

Postnatal lifestyle programme prevents weight gain after gestational diabetes

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