Abstract
Gestational diabetes mellitus (GDM) disproportionately affects Hispanic women, predisposing them to elevated rates of postpartum weight retention (PPWR) and an accelerated risk of progressing to type 2 diabetes mellitus (T2D). Standard postpartum care often fails to address specific cultural, linguistic, and socioeconomic realities, resulting in poor long-term adherence. This randomized controlled pilot study evaluated the feasibility and preliminary efficacy of a culturally tailored, community-based intervention led by bilingual Community Health Workers (promotoras) compared to standard care. Eighty-two pregnant Hispanic women diagnosed with GDM were randomized (1:1) to either a 12-session lifestyle intervention incorporating culturally adapted dietary education, participatory cooking, and physical activity support, or standard clinical care. Primary outcomes included PPWR and glycemic markers (HbA1c and 75-g oral glucose tolerance test [OGTT] completion) assessed at 6 weeks and 6 months postpartum. At 6 months postpartum, intervention participants exhibited significantly lower mean PPWR compared to control participants (1.8 ± 2.1 kg vs. 4.6 ± 2.7 kg; p < 0.001) and demonstrated a significantly higher rate of postpartum OGTT completion (73.2% vs. 41.5%; p = 0.004). Furthermore, mean HbA1c at 6 months postpartum was significantly lower in the intervention cohort (5.4% ± 0.3% vs. 5.8% ± 0.4%; p = 0.012). Culturally aligned promotora-delivered lifestyle interventions demonstrate potent feasibility and efficacy in attenuating postpartum weight retention and improving metabolic surveillance among Hispanic women with GDM.
