UPBEAT, RADIEL, and DALI : what's the difference?

We congratulate Poston and colleagues1 on completion of UPBEAT, a meticulous randomised controlled trial. Unfortunately, their combined healthy eating and physical activity intervention, as with the older LIMIT trial, 2 did not prevent gestational diabetes compared with standard antenatal care. We subsequently published the DALI Lifestyle Pilot3 showing that women in our healthy eating intervention gained less weight (-2"¢6 kg [95% CI -4"¢9 to -0"¢2]), with a greater decrease in fasting glucose (-0"¢3 mmol/L [-0"¢4 to -0"¢1]) and a non-significant 33% reduction in gestational diabetes, compared with the physical activity intervention (odds ratio 0"¢67 [95% CI 0"¢25; 1"¢75; p=0"¢41]). On July 29, another randomised controlled trial4 of a healthy eating and physical activity intervention (RADIEL) reported a 39% (2-60) reduction in gestational diabetes, although this result was only significant after adjustment for baseline data (which were similar between groups).