Last updated August 25, 2026
Key finding
The estimated incidence of diabetes without treatment was 37.4%, compared to 20.0% with intensive lifestyle intervention.
This study evaluated a clinical prediction model for diabetes risk in women with prior gestational diabetes, comparing the effects of intensive lifestyle intervention and metformin against a placebo.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Extended (5–20+ y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated a clinical prediction model for diabetes risk in women with prior gestational diabetes, comparing the effects of intensive lifestyle intervention and metformin against a placebo.
This research highlights the importance of preventive strategies for women with a history of gestational diabetes, a group at high risk for developing type 2 diabetes. By demonstrating effective interventions, healthcare providers can better manage and reduce diabetes risk in this population, potentially improving long-term health outcomes.
Effectiveness of interventions remains unclear despite significant findings. Study may not be generalizable to all populations of women with gestational diabetes. Limited long-term follow-up data to assess sustained effects of interventions.
Published in
Publication details and source links for this paper.
Bernice M, Alan S, Oksana P, Yinglin X, Ben G, Andreas B. A clinical prediction model for diabetes risk in women with prior gestational diabetes. PLOS ONE. 2021;16(6):e0252501. doi:10.1371/journal.pone.0252501
The incidence of diabetes was reduced to 20.0% with intensive lifestyle intervention compared to 37.4% without treatment.
The incidence of diabetes was similarly reduced to 20.0% with metformin treatment compared to 37.4% without treatment.
Both interventions showed a statistically significant decrease in diabetes incidence with a ratio of 0.534 (p=0.001).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Lifestyle intervention for prediabetes, Metformin and Gestational diabetes mellitus incidence.
This study contributes evidence to
Primary intervention
Lifestyle intervention for prediabetes
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
1
Related topics
2
Evidence pairs
32
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Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence topic
Save evidence
Intervention
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Core evidence
The primary outcomes reported in this study.
Lifestyle intervention for prediabetes → Gestational diabetes mellitus incidence
Lifestyle intervention for prediabetes → Gestational diabetes mellitus incidence
Metformin → Gestational diabetes mellitus incidence
Metformin → Gestational diabetes mellitus incidence
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Lifestyle intervention for prediabetes and Diabetes Incidence and Prevention, Metformin Therapies and Diabetes Incidence and Prevention.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring Diabetes Incidence and Prevention
Measures Diabetes Incidence and Prevention as a key outcome.
All studies on Lifestyle intervention for prediabetes
Contributes to Lifestyle intervention for prediabetes evidence base.
All studies on Metformin Therapies
Contributes to Metformin Therapies evidence base.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Metformin Therapies appears to improve Diabetes Incidence and Prevention.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Gestational diabetes mellitus incidence
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Lifestyle intervention for prediabetes appears to improve Gestational diabetes mellitus incidence.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Gestational diabetes mellitus incidence
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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