The Avoiding Diabetes After Pregnancy Trial in Moms Program: Feasibility of a Diabetes Prevention Program for Women With Recent Gestational Diabetes Mellitus.

Lorraine L Lipscombe, Faith Delos-Reyes, Andrea J Glenn, Stephanie de Sequeira, Xinyun Liang, Shannan Grant, Kevin E Thorpe, Jennifer A D Price

Journal: Canadian journal of diabetes 2020;43(8):613-620

PMID: 31669188

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

Our aim in this study was to evaluate the feasibility of a home-based diabetes prevention program, delivered by interdisciplinary certified diabetes educators (CDEs), and customized for postpartum women with recent gestational diabetes mellitus (GDM).

METHODS

This pilot randomized trial recruited women with GDM from 24 to 40 weeks gestation from 4 centres, and trained 10 CDEs in behaviour coaching, physical activity (PA) and low glycemic index education. Women were randomized after 3 months postpartum to standard care (1 visit) or 1 of 3 24-week coaching interventions (1 visit and 12 telephone calls): i) PA and diet, ii) PA only or iii) diet only. Feasibility outcomes included recruitment, retention, adherence and satisfaction.

RESULTS

Of 1,342 eligible patients, 392 were actively invited (29.3%) and 227 (16.9%) consented. Of these, 149 (65.6%) were randomized postpartum, of whom 131 (87.9%) started the program and 105 (70.5%) attended the final assessment. Intervention arm participants completed a median 75% (interquartile range, 50% to 92%) of telephone calls. Visit and call duration were a mean 71.4 (standard deviation, 13.8) and 18.1 (standard deviation, 6.5) minutes, respectively. Participants reported excellent/very good satisfaction 73% of the time, and 87% would recommend the program to others.

CONCLUSIONS

A home-based diabetes prevention program customized for postpartum women with GDM can be feasibly delivered by CDEs, and it is associated with >70% retention, adherence and satisfaction.

Address: Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address: [email protected].; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.; Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Applied Human Nutrition, Mount St Vincent's University, Halifax, Nova Scotia, Canada; Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, Nova Scotia, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

DOI: 10.1016/j.jcjd.2019.08.019

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MeSH Terms: Adult, Diabetes, Gestational, Exercise, Feasibility Studies, Female, Health Education, Health Educators, Health Plan Implementation, Humans, Patient Satisfaction, Pilot Projects, Pregnancy, Secondary Prevention