None listed
Conditions
Brief summary
The prevalence of Gestational Diabetes (GDM) in Australia is approximately 5%-8%, with up to one third of all parous women who develop type 2 diabetes having a previous history of GDM . Research to determine strategies to delay or prevent the development of or progression to diabetes is vital, particularly in population groups that are at higher risk, such as GDM, and obese women (BMI.>25). A pilot randomised controlled trial (RCT) conducted at Mater Mothers Hospital suggested that a post partum intervention designed to increase physical activity in women with previous GDM may be feasible. A recent study in the United States recruited women with recent GDM into an RCT where the control group received usual care and the intervention group received a web based pedometer program. Dietary intervention has been proven to increase probability of weight loss, so a strategy of combining both a pedometer and nutrition based program may prove to be more successful in long term improvement in a healthy lifestyle to prevent type 2 diabetes. The aim of this study is to develop long term statergies for women who develop GDM during their pregnancy and are overweight (BMI > 25) to improve their lifestyle to possibly prevent Type 2 diabetes. This randomised controlled trial is a pedometer - based inervention to encourage physical activity , combined with nutrition coaching, and will possibly result in an increased weight loss, improved insulin sensitivity and increased physical activity when compared with standard care. This project aims to take another step towards the larger scale issue of providing adequate, evidence based follow up care for women who develop GDM in their pregnancies.
Interventions
In addition to the same feedback and printed resources offered to women in the control group, women allocated to the intervention group will receive a specifically designed "USB pedometer". The pedometer is designed to be worn during waking hours, especially during exercise, and will allow the user to upload their data in to a tailored web based program that offers tips, ideas and motivation to the participants over the 3 month intervention. The user will be encouraged to log on weekly and will
In addition to the same feedback and printed resources offered to women in the control group, women allocated to the intervention group will receive a specifically designed "USB pedometer". The pedometer is designed to be worn during waking hours, especially during exercise, and will allow the user to upload their data in to a tailored web based program that offers tips, ideas and motivation to the participants over the 3 month intervention. The user will be encouraged to log on weekly and will receive weekly goals, feedback on their walking progress, and messages and “tips” regarding diet and excercise, targeted at diabetes prevention. The program content will be designed in collaboration with the University of Michigan, where a similar project was performed in 2009 incorporating an exercise intervention without the dietary component. The participants in this arm of the study will also receive a Nutritional Coaching course run by Dieticians. This consists of one individual session with a dietician for baseline dietary assessment and a personalised program, followed by 4 monthly group sessions informed by evidence based behavioural modification concepts with monthly followups by phone at a mutually agreed time. SMS text messaging will also be utilised if available as a contact point for reinforcement of health promotion messages. To assess longer term effects, the intervention group participants will be offered a maintenance program for a further three months immediatley following the intervention. This will consist of monthly face-to-face consultaion and weight for 3 months. After this additional time they will be re-evaluated, where anthropometric observations, fasting blood tests and questionnaires relating to diet, activity and lifestylewill be repeated.
Sponsors
Ann Peacock
Study design
Allocation
Randomised controlled trial
Primary purpose
Prevention
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
been diagnosed as having and treated for GDM at the Mater Mothers Hospital. given birth at the Mater Mothers’ Hospital in the previous 6 months to 2 years. a BMI > 25kg/m2 based on current self reported height and weight. routine access to a computer and possess adequate computer skills to navigate web sites and e-mail. understood that the primary physical activity will be walking
Exclusion criteria
currently pregnant or planning to be pregnant in the next year. already diagnosed with T2DM. not sufficiently fluent in spoken and written English to be able to fully participate in the study. taking medications which interfere with glucose metabolism such as metformin or prednisone. suffering from any mental or physical disability which would interfere with their participation in the study.
Outcome results
None listed