RESEARCH SUMMARY

Telephone-based lifestyle education reduces gestational diabetes risk by 60% in high-risk Iranian women

Moderate confidence
Some Concerns bias
Last updated May 7, 2026

Key takeaway:

A 12-week telephone-based lifestyle education program reduced gestational diabetes risk by 60% in high-risk Iranian women compared to routine prenatal care, with additional benefits for weight management and self-care behaviors.

Study at a glance

Study type

RCTs

duration

Short-Term (≤3 mo)

Intervention

Telephone counseling

Outcomes

Gestational diabetes mellitus incidence, BMI, Treatment adherence

Funding

Non-industry sponsored

What was studied

Telephone-based lifestyle education to prevent gestational diabetes in high-risk Iranian women

What they found

  • ↓ Gestational diabetes incidence (10.0% vs 24.4%, 60% relative risk reduction)
  • ↓ BMI increase during pregnancy (0.6 vs 1.3 kg/m²)
  • ↑ Adherence to healthy diet, physical activity, and glucose monitoring

mainEffects

↓ Gestational diabetes incidence (10.0% vs 24.4%, 60% relative risk reduction)

↓ BMI increase during pregnancy (0.6 vs 1.3 kg/m²)

↑ Adherence to healthy diet, physical activity, and glucose monitoring

Evidence Suggest

  • Telephone-based lifestyle education reduced gestational diabetes risk by 60% in high-risk pregnant women
  • The intervention was associated with better weight management during pregnancy
  • Women receiving telephone counseling had significantly better adherence to self-care behaviors including healthy eating (75% vs 50%), regular physical activity (68% vs 45%), and blood glucose monitoring (63% vs 44%)

Who this applies to

This intervention was tested in high-risk pregnant women in Iran with at least two major risk factors for gestational diabetes including high BMI (≥30 kg/m²), family history of diabetes, previous gestational diabetes, or previous delivery of a large baby. Participants were ages 18-35 and less than 12 weeks pregnant at enrollment.

Keep in Mind

This study was conducted in Iran where dietary patterns, healthcare access, and cultural factors differ from Western populations. The intervention was delivered in Persian and incorporated traditional Iranian foods into healthy eating recommendations. Results may not directly translate to other settings. The study relied on self-reported measures of adherence to diet and physical activity, which participants may have overestimated. Because participants knew their group assignment, placebo effects and reporting bias may have influenced results. The study did not follow participants after delivery to assess long-term outcomes for mothers or babies.

Between the Lines

  • Participants and care providers were not blinded to treatment assignment, which could introduce bias
  • Adherence to self-care behaviors was self-reported, raising potential for reporting bias and overestimation of compliance
  • The intervention was culturally tailored to Iranian dietary patterns and may not generalize directly to other populations
  • Long-term maternal and neonatal outcomes beyond 28 weeks were not assessed

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Sources

guidelines

American Diabetes Association Standards of Care in Diabetes—2025: Management of Diabetes in Pregnancy

The ADA clinical practice guidelines recommend structured lifestyle interventions including medical nutrition therapy and physical activity counseling for pregnant women at high risk for gestational diabetes to prevent or delay onset.
guidelines

Telemedicine in Maternal Health - ACOG Committee Opinion

The American College of Obstetricians and Gynecologists recognizes telemedicine including telephone-based interventions as effective tools for prenatal care delivery, particularly valuable for reaching underserved populations and providing continuous support for behavior change.
guidelines

2012 Position Statement on Healthcare Disparities | American Association of Clinical Endocrinology

Since its inception, AACE has advocated for the finest in endocrine education and state-of-the-art health-care delivery without regard to race, ethnicity, gender, age, country of origin, economic status, lifestyle, sexual orientation, or domestic living arrangements. AACE actively opposes the continued existence of endocrine healthcare disparities in the USA, and will devote its resources to diminish these disparities. AACE members, staff, partners, and others with whom AACE interacts will continually advocate for understanding, prevention, and elimination of endocrine health care disparities.
guidelines

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease | American Association of Clinical Endocrinology

Arnett DK, Blumenthal RS, Albert MA et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation 2019:Cir0000000000000678
guidelines

2022 Clinical Practice Guideline for Development of a Diabetes Mellitus Comprehensive Care Plan | American Association of Clinical Endocrinology

This updated guideline provides recommendations for the care and management of people with or at risk for diabetes mellitus at every stage, including prevention, diagnosis, and treatment.
guidelines

AACE Position Statement: Coronavirus (COVID-19) and People with Adrenal Insufficiency and Cushing’s Syndrome | American Association of Clinical Endocrinology

With the novel COVID-19 virus continuing to spread, it is crucial to adhere to the advice from experts and the Centers for Disease Control and Prevention (CDC) to help reduce risk of infection for individuals and the population at large. This is particularly important for people with adrenal insufficiency and people with uncontrolled Cushing’s Syndrome.
guidelines

Alan J Garber, MD, PhD, MACE, Lectureship for the Prevention and Management of the Complications of Diabetes | American Association of Clinical Endocrinology

Dr. Hirsch is Professor of Medicine at the University of Washington School of Medicine.
healthAuthorities

Gestational Diabetes Mellitus - WHO Fact Sheet

The World Health Organization recognizes gestational diabetes as a major public health concern affecting maternal and child health worldwide, with prevalence particularly high in Middle Eastern populations. WHO emphasizes the importance of early screening and prevention strategies in high-risk women.
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