It s never too early . . . to prevent diabetes

1. It�s never too early . . . to prevent diabetes Outreach Goals: ? number of women with history of GDM who develop diabetes ? awareness of health risks for children of that pregnancy ? provider counseling about future health risks and steps to take to prevent diabetes ? adoption and maintenance of healthy behaviors Women with a history of gestational diabetes provide a unique opportunity for identification of, and intervention in, a population at high risk for developing diabetes. The National Diabetes Education Program (N-D-E-P) is a joint program of the NIH and CDC, sponsored by HHS. NDEP is joining forces with the Office of Research on Women�s Health to raise awareness about the future health risks that gestational diabetes places on the mother and her offspring of that pregnancy. This campaign is informed by the results of the Diabetes Prevention Program (DPP) clinical trial sponsored by NIH � see appendix for background. Outreach Goals: (on slide) ? number of women with history of GDM who develop diabetes ? awareness of families about health risks for offspring of pregnancy affected by GDM ? health care professional counseling about future health risks and steps to take to prevent diabetes ? adoption and maintenance of healthy behaviors Women with a history of gestational diabetes provide a unique opportunity for identification of, and intervention in, a population at high risk for developing diabetes. The National Diabetes Education Program (N-D-E-P) is a joint program of the NIH and CDC, sponsored by HHS. NDEP is joining forces with the Office of Research on Women�s Health to raise awareness about the future health risks that gestational diabetes places on the mother and her offspring of that pregnancy. This campaign is informed by the results of the Diabetes Prevention Program (DPP) clinical trial sponsored by NIH � see appendix for background. Outreach Goals: (on slide) ? number of women with history of GDM who develop diabetes ? awareness of families about health risks for offspring of pregnancy affected by GDM ? health care professional counseling about future health risks and steps to take to prevent diabetes ? adoption and maintenance of healthy behaviors

2. What you can do to help Counsel women to take action NOW . . . Continue with the positive lifestyle habits after delivery Get screened 6 to 12 weeks post partum and then at least every 3 years Breastfeed Aim to get back to your pre-pregnancy weight within 6 to 12 months, then if still overweight, work to lose 5 to 7 % body weight over time Make healthy food choices and eat smaller portions Be active 30 minutes 5 days a week What can we, as primary providers for this group of women, do to help? Counsel women to take action now to prevent diabetes later. Key points: Continue with the positive lifestyle habits made to manage gestational diabetes after delivery Get screened 6 to 12 weeks post partum and then at least every 3 years for diabetes Breastfeed Aim to get back to your pre-pregnancy weight within 6 to 12 months, then if you still weigh too much, work to lose weight over time. The DPP (see Appendix) showed that losing 5 to 7% of body weight and regular physical activity 30 minutes a day, 5 days a week was effective in reducing the risk of the development of diabetes by 50%. At the 10 year follow up to the DPP, a 34% risk reduction was seen. Make healthy food choices and eat smaller portions When you talk with patients during pregnancy, stress the future risk of diabetes for the women and the future risk for obesity and type 2 diabetes in the offspring of the GDM pregnancy. What can we, as primary providers for this group of women, do to help? Counsel women to take action now to prevent diabetes later. Key points: Continue with the positive lifestyle habits made to manage gestational diabetes after delivery Get screened 6 to 12 weeks post partum and then at least every 3 years for diabetes Breastfeed Aim to get back to your pre-pregnancy weight within 6 to 12 months, then if you still weigh too much, work to lose weight over time. The DPP (see Appendix) showed that losing 5 to 7% of body weight and regular physical activity 30 minutes a day, 5 days a week was effective in reducing the risk of the development of diabetes by 50%. At the 10 year follow up to the DPP, a 34% risk reduction was seen. Make healthy food choices and eat smaller portions When you talk with patients during pregnancy, stress the future risk of diabetes for the women and the future risk for obesity and type 2 diabetes in the offspring of the GDM pregnancy.

3. NDEP Resources Information for patients in English: Tip sheet for women with history of GDM: ndep.nih.gov/am-i-at-risk/gdm GAMEPLAN for preventing type 2 diabetes The National Diabetes Education program has free patient education materials. Our products are in the public domain and you can personalize them with your office information and print locally. - Tip sheet for women with a history of GDM � the direct link is on this slide - GAMEPLAN for preventing type 2 diabetesThe National Diabetes Education program has free patient education materials. Our products are in the public domain and you can personalize them with your office information and print locally. - Tip sheet for women with a history of GDM � the direct link is on this slide - GAMEPLAN for preventing type 2 diabetes

4. NDEP Resources Information for patients in Spanish: Tip sheet for women with history of GDM: ndep.nih.gov//publications/OnlineVersion.aspx?NdepId=NDEP-89 GAMEPLAN for preventing type 2 diabetes These prevention resource are also available in Spanish. - Tip sheet for women with a history of GDM � the direct link is on this slide - GAMEPLAN for preventing type 2 diabetesThese prevention resource are also available in Spanish. - Tip sheet for women with a history of GDM � the direct link is on this slide - GAMEPLAN for preventing type 2 diabetes

5. NDEP Resources Support for Behavior Change Resource: ndep.nih.gov/sbcr The Support for Behavior Change Resource is an on-line resource of behavior change tools and programs (the direct link is on the slide). This user-friendly resource was developed to provide easy access to existing research articles, tools, and programs that address the �how to� of psychosocial issues, lifestyle, and behavior change. All materials have been independently reviewed by experts in psychosocial issues and behavior change.The Support for Behavior Change Resource is an on-line resource of behavior change tools and programs (the direct link is on the slide). This user-friendly resource was developed to provide easy access to existing research articles, tools, and programs that address the �how to� of psychosocial issues, lifestyle, and behavior change. All materials have been independently reviewed by experts in psychosocial issues and behavior change.

6. Appendix

7. Diabetes Prevention Program The Diabetes Prevention Program (DPP) was a comparative effectiveness study that showed that lifestyle intervention can delay or prevent the onset of type 2 diabetes in people at high risk. Women with GDM had a higher incidence of diabetes than others BUT comparable risk reduction. Risk reduction: Intensive lifestyle group: 50% Metformin group: 31%