Women with recent GDM have increased risk of developing type 2 diabetes. This trial investigated a 12-month lifestyle intervention vs usual care at 19 urban hospitals in India, Sri Lanka, and Bangladesh.

A total of 1823 women were followed up post-partum for an assessment of diabetes status. Among them, 1601 were randomised (800 to intervention group). Among the 800 participants in the intervention, 644 women (80.5%) received all program content. The COVID-19 lockdowns did impact the delivery model. Among 644 participants, who engaged in all group sessions, 476 women [73.9%] received some or all content through individual engagement, and 315 women [48.9%] received some or all content remotely. No significant difference was found between the two groups in worsening of glycaemic status. However, this study did find that a large proportion of women in South Asian urban settings developed dysglycemia soon after a GDM-affected pregnancy. The findings suggest that alternate or additional approaches are needed, especially among high-risk individuals.