Diabetes Mellitus Clinical Trial
Official title:
Healthy Lifestyle in Pregnancy
Background:
- Women can gain too much weight or develop diabetes during pregnancy. If the mother is
overweight or has diabetes during pregnancy, her baby may also be at risk of being overweight
or developing diabetes. A woman s chance of getting diabetes increases if her parents or
family members are overweight or have diabetes. Poor diet and exercise habits can also lead
to weight gain and diabetes. Researchers want to study how best to improve the health of
pregnant women and their children. They will do so by providing healthy lifestyle counseling
for women receiving prenatal care at the Phoenix Indian Medical Center.
Objectives:
- To study the effectiveness of healthy lifestyle counseling for overweight and/or diabetic
pregnant women.
Eligibility:
- Women at least 18 years of age who will receive pregnancy care at the Phoenix Indian
Medical Center.
- Participants must be overweight or obese. They may or may not have diabetes.
Design:
- Participants will receive standard prenatal care from the midwives, doctors, and
dietitians at the Phoenix Indian Medical Center.
- Participants will work with National Institutes of Health staff for about 2 hours every
week. These sessions may include phone calls, home visits, or group meetings.
- Participants will have a total of nine measurement visits. The first visit will be at or
before 16 weeks of pregnancy. The next three visits will be within a week of the first
visit. Another four visits will take place between 23 and 28 weeks of pregnancy.
- Participants will have different tests through their pregnancy. They will wear heart
monitors and wrist monitors to measure heart rate and movement. They will provide
information on their eating habits, physical activity, and mood and feelings during
pregnancy. Blood samples will be collected to measure blood glucose (sugar) levels.
- Participants will receive counseling on healthy eating and physical activity habits.
They will be encouraged to invite friends or family members to learn more about healthy
lifestyle choices.
- The study will end with the final visit about 6 to 8 weeks after giving birth. A final
blood sample will be collected. Participants will be asked questions about mood and
feelings.
American Indians are at high risk for developing type 2 diabetes mellitus (T2DM) and its
complications. Major factors responsible for this finding include obesity and intrauterine
exposure to diabetes; the latter increases the risk of diabetes in the offspring particularly
during childhood and adolescence. This study is designed to evaluate the feasibility of
conducting an intensive lifestyle intervention (ILI) in adult (age greater than or equal to
18 years) pregnant women of any race or ethnicity who are eligible for prenatal care at
Phoenix Indian Medical Center (PIMC). Most of these women or their fetuses will be of
American Indian heritage. Interventions will be provided to overweight and obese pregnant
women who may have diabetes, develop gestational diabetes (GDM), or be at high risk of
developing diabetes. We will evaluate our ability to maintain engagement and motivate
adoption of a healthy diet and increased physical activity. The lifestyle intervention will
be patterned after the Diabetes Prevention Program (DPP) that prevented or delayed the onset
of diabetes in non pregnant adults; the interventions will be modified to be appropriate in
pregnancy. A major modification will be to encourage managed weight gain instead of weight
loss. For women who have or develop diabetes, interventions will include coaching to optimize
glycemic control. In this protocol, we will seek to identify strategies that can successfully
accomplish these goals. Results from this study will permit us to formulate appropriate
intervention strategies for a large randomized clinical study to evaluate the impact of an
intensive lifestyle intervention on pregnant women and their offspring.
The project will be conducted in collaboration between the nurse midwifery and obstetrics
services at Phoenix Indian Medical Center (PIMC) and the National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK). Important feasibility measures include evaluating our
ability to enroll and retain pregnant women in a lifestyle intervention program and collect
serial measures of gestational weight and glucose, objective measures of physical activity,
and nutritional questionnaires.
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