Postnatal women with a history of gestational diabetes in a recent pregnancy, and who are overweight Pregnancy and Childbirth Diabetes mellitus in pregnancy, unspecified
Conditions
Interventions
The experimental arm will be enrolled in a lifestyle intervention comprising a one hour educational programme delivered during the time they attend for the routine postnatal oral glucose tolerance tes
Sponsors
Belfast Health and Social Care Trust (UK)
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Aged 18 years or older 2. History of gestational diabetes mellitus in last pregnancy. The definition of GDM will be according to the new International Association of the Diabetes in Pregnancy Study Groups (IADPSG) consensus criteria (7), following a 75g oral glucose tolerance test (OGTT) (fasting glucose =5.1 mmol/l or 1h plasma glucose = 10 mmol/l or 2h plasma glucose =8.5 mmol/l). 3. Body mass index (BMI) = 25 kg/m2 at booking (if less than 16 weeks, otherwise based on reported pre pregnancy weight) and BMI = 25 kg/m2 at their postnatal OGTT visit. A BMI equivalent to 25 kg/m2 will be used for non Caucasian subjects. 4. Normal or impaired glucose tolerance or impaired fasting glucose (IFG/IGT) on postnatal glucose tolerance testing. 5. Mothers will be encouraged to continue to breast feed. The aim will be to recruit mothers who are not planning a further pregnancy in the next 6 months.
Exclusion criteria
Exclusion criteria: 1. Pregnancy outcome resulting in an anomaly or still birth 2. History of diabetes outside pregnancy or diagnosis of diabetes on the postnatal OGTT 3. Heart, liver, or chronic renal disease 4. Medications that adversely affect glucose tolerance (e.g. steroids) 5. Contraindications to participating in moderate physical activity 6. Moderate/severe depressive illness 7. Excess alcohol consumption 8. Planning another pregnancy in the next 6 months 9. Taking part in another research study 10. Inability to adequately understand verbal explanations or written information given in English, or who have special communication needs 11. Already attending a CWMO NB: Women will not know if they have a diagnosis of diabetes outside pregnancy until several days after the OGTT appointment (visit 1). Women who are diagnosed with persisting diabetes following the postnatal OGTT will be contacted by their diabetes care team for follow up and will be excluded from the study post randomisation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Weight at 6 months (taking into account any difference in weight at baseline between the intervention and control groups) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Fasting glucose and 2h OGTT glucose (optional) 2. Waist circumference 3. Pedometer counts, change from baseline at 6 months (intervention group only) 4. Questionnaire data pertaining to physical activity, nutrient intake as estimated by food diary, General Health and Well Being, Motivation to change and Risk Perception Survey for Developing Diabetes (RPS-DD) | — |
Countries
United Kingdom
Outcome results
None listed