2.2. Trial overview

In the LIVING trial, ¹³ we evaluated women with a recent diagnosis of GDM. We randomized 1601 women who did not have diabetes at the first postpartum visit (prerandomization) in 1:1 to lifestyle intervention vs usual care. The primary outcome was worsening of glycemia (normal to prediabetes/diabetes or prediabetes to diabetes) based on OGTT using American Diabetes Association criteria. ¹⁴ The intervention did not affect the primary outcome with no difference in glycemic status compared to usual care (25.5% vs 27.1%; hazard ratio, 0.92 [95% confidence interval (CI), 0.76–1.12]; p = .42). Due to the lack of significant differences in the primary and secondary outcomes, including weight, and diabetes rates, we used the dataset from both arms for the current study. In addition, we included those who underwent testing (postpartum OGTT) as part of the baseline visit but did not undergo randomization either due to the detection of diabetes or were excluded/not enrolled in the trial for other reasons.