Avoiding Diabetes after Pregnancy Trial in Moms (ADAPT-M): Feasibility of a Diabetes Prevention Program for Women with Recent Gestational Diabetes Mellitus (GDM)

Abstract Aims 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 four centres, and trained 10 CDEs in behaviour coaching, physical activity (PA), and low glycemic index education. Women were randomized after three 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 iii) diet only. Feasibility outcomes included recruitment, retention, adherence, and satisfaction. Results Of 1342 eligible patients, 392 were actively invited (29.3%) and 227 (16.9%) consented. Of those, 149 (65.6%) were randomized postpartum, of which 131 (87.9%) started the program and 105 (70.5%) attended the final assessment. Intervention arm participants completed a median 75% (interquartile range, IQR 50 to 92%) of telephone calls. Visit and call duration were a mean 71.4 (SD ± 13.8) and 18.1 (SD ± 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 is associated with over 70% retention, adherence, and satisfaction.