None listed
Conditions
Brief summary
Elevated blood glucose levels developing for the first time in pregnancy (Gestational Diabetes Mellitus; GDM) is a common complication of pregnancy in our local community. In most cases, the diabetes will resolve after the baby is delivered, although it may return years later (type 2 diabetes). However, we have found that in certain women there is a high chance that the blood glucose levels will remain elevated after pregnancy, with adverse effects on the health of the woman in the long-term, and potentially also on the baby during a subsequent pregnancy. There is strong evidence that diabetes in individuals at high risk can be prevented through lifestyle intervention with diet and exercise. Our study will determine whether in high-risk women with GDM, we can prevent elevated blood glucose levels in the first year after their pregnancy by offering them one-on-one advice about a healthy lifestyle by a health coach (a nurse or other allied health professional) during their pregnancy and for the first year after giving birth. The women who participate in this trial will mostly see their health coach during routine antenatal visits so that inconvenience to the patient will be minimized. We will compare high risk women who had a health coach to those who did not i.e. outcomes during pregnancy and in the first year after giving birth. If our trial is successful, we believe our program could easily be incorporated into routine clinical care in our antenatal clinics..
Interventions
Health coaching of high risk women diagnosed with GDM is delivered by midwifes who have undergone training in health coaching (Health Change Australia; health change.com, Core Training Part 1 and Part 2 ). The initial meeting is face-to-face at a routine antenatal clinic appointment. Subsequent follow-up is by weekly telephone call or email (according to participant preference), or at scheduled antenatal clinic visits (one-to-one interview), until delivery. The Coach’s role is to encourage and m
Health coaching of high risk women diagnosed with GDM is delivered by midwifes who have undergone training in health coaching (Health Change Australia; health change.com, Core Training Part 1 and Part 2 ). The initial meeting is face-to-face at a routine antenatal clinic appointment. Subsequent follow-up is by weekly telephone call or email (according to participant preference), or at scheduled antenatal clinic visits (one-to-one interview), until delivery. The Coach’s role is to encourage and monitor the woman’s adherence to the GDM diet and exercise program (as prescribed by the Diabetes in Pregnancy Service), to monitor weight, to encourage breastfeeding, and to carry out follow-up post-partum (OGTT results at 6-12 weeks post-partum and 12 months postpartum, weight at 6 and 12 months postpartum). Women in the Intervention group also attend a one-on-one appointment (45 min-1 hr duration) with an exercise physiologist during pregnancy (usually within the first month after enrolment in the study) to set out specific individualized goals for regular physical activity pre- and post-partum. The number of contacts with health coaches is recorded and is a secondary outcome of the trial.
Sponsors
Dr Anne Corbould
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
1. diagnosis of GDM according to ADIPS criteria 2012: gestation 30 weeks or less 2. Age 18 years or above 3. Singleton pregnancy 4. English speaker 5. BMI 30 kg/m2 or above at booking
Exclusion criteria
Non-singleton pregnancy Other major pregnancy complications or chronic health problems. pre-existing type 1 or type 2 DM – pre-existing impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) is allowed
Outcome results
None listed