Exploring Healthy Lifestyle Interventions among Women with Gestational Diabetes Mellitus in the Indian Subcontinent

Aim and background: One of the major public health concerns in the Indian subcontinent is gestational diabetes mellitus (GDM).Women with prior GDM are 50% more likely to develop type 2 diabetes (T2D) in the future, along with an increased risk of cardiovascular diseases (CVDs).Lifestyle interventions play a major role in preventing T2D and related complications among GDM women, yet it is underexplored, and there is a limited availability of evidence in this area.Methods: To systematically review and consolidate the existing knowledge and approaches in the Indian subcontinent for designing culturally and contextually relevant multimodal interventions, aimed at reducing type 2 diabetes mellitus (T2DM) risk in GDM women.The protocol was registered on PROSPERO in May 2024 (record number: CRD42024544564).We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Articles published between January 2010 and July 2024 were searched in databases such as PubMed, Cochrane, and Google Scholar.Using the Cochrane risk of bias 2 tool, the risk of bias was examined.Intervention integrity was evaluated using the Dane and Schneider framework.Of 844 identified records, eight studies met the inclusion criteria (lifestyle interventions in the Indian subcontinent postpartum GDM women).Results: Lifestyle interventions reduced weight, depression, insulin use, and T2DM incidence while improving knowledge, postpartum screening, and glycemic control.However, heterogeneous outcomes with inconsistent statistical significance arose from variations in intervention intensity, duration, demographics, small sample sizes, and short follow-ups, underscoring preliminary evidence despite positive trends.Conclusion: Lifestyle interventions lowered T2DM risk in Indian subcontinent GDM women.Larger, high-quality randomized controlled trials (RCTs) with extended follow-ups are needed to identify optimal strategies.Future studies should prioritize context-specific, culturally scalable, cost-effective models addressing social determinants to enhance accessibility and adherence.Clinical significance: Lifestyle interventions significantly lower T2DM risk in postpartum GDM women from the Indian subcontinent by promoting sustainable metabolic and behavioral improvements.Larger RCTs with extended follow-ups and culturally tailored, cost-effective models addressing social determinants are crucial to refine accessible strategies and confirm efficacy.