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Postpartum Dietary Interventions and Cardiometabolic Profiles After Pregnancies Complicated by Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis

Lookup NU author(s): Dr Peipei Liu

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Abstract

© 2026 by the American Diabetes Association.BACKGROUND Gestational diabetes mellitus (GDM) confers substantial long-term cardiometabolic risk. The postpartum period represents a critical window for intervention, but the benefits of dietary interventions on cardiometabolic profiles in women with prior GDM remain unclear. PURPOSE To evaluate whether postpartum dietary interventions improved cardiometabolic profiles in women with GDM. DATA SOURCES Six databases were searched from 1 January 1980–31 December 2025. STUDY SELECTION Twenty-one randomized controlled trials (RCTs) met inclusion criteria. DATA EXTRACTION Data extraction and risk-of-bias assessment followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SYNTHESIS Meta-analyses pooled mean differences (MDs) with 95% CIs using a random-effects model. Intermediate cardiometabolic surrogate markers, such as BMI, waist circumfer-ence, weight, fasting and 2-h blood glucose, HOMA of insulin resistance (HOMA-IR), hemoglobin A1c (HbA1c), systolic and diastolic blood pressure, lipids, and inflammatory biomarkers were evaluated. The meta-analysis included 19 RCTs (participants were aged 18–45 years; sample size: 23 to 1,639; follow-up: 12 weeks–3 years). Compared with standard care, postnatal dietary interventions significantly reduced BMI (MD −0.46 kg/m2; 95% CI −0.71, −0.20), waist circumference (−1.47 cm; −2.39, −0.55), weight (−0.73 kg; −1.19, −0.27), HOMA-IR (−0.55; −1.04, −0.06), and HbA1c (−0.24%; −0.46, −0.02). No improvements were found for other markers. LIMITATIONS Heterogeneity across studies, variable adherence to counseling-based interventions, and comprehensive standard postpartum care may have limited observed effects. CONCLUSIONS Postpartum dietary interventions yield modest but statistically significant improvements in key cardiometabolic indicators among women with prior GDM without overt disease, highlighting the postpartum period as an important window to optimize intermediate cardiometabolic markers.

Publication metadata

Author(s): Phee AAT, Foo RX, Guivarch C, Liu P, Gneezy R, Shanmugan S, Zhang C, Shen J, Wong WCW, Cheung KW, Chan KKL, Li L-J

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2026

Volume: 49

Issue: 8

Pages: 1507-1520

Online publication date: 05/06/2026

Acceptance date: 05/05/2026

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association Inc.

URL: https://doi.org/10.2337/dc26-0057

DOI: 10.2337/dc26-0057

PubMed id: 42247277

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