Gestational Diabetes Clinical Trial
Official title:
eHealth in Treatment of Gestational Diabetes - eMOM GDM -Study (Phase 2)
The overall aim of the eMOM GDM-project is to develop and evaluate a novel system to clinical decision making and patient behavior change in treatment of GDM, combining diet, physical activity, sleep, heart rate (e.g. stress), and glucose monitoring within a single system (the eMOM GDM application), and linking the developed application tool for the normal health care system in a new way. In this second phase of the project, the effect of eMOM GDM application on maternal and neonatal outcomes will be evaluated in a randomized controlled study design. The follow-up study continues until 3 months postpartum.
200 women with gestational diabetes will be randomized into the intervention and the control group at gestational week (GW) 24-28. Participants in the intervention group will use the eMOM GDM -application one week/month until delivery. The participants in the intervention and the control group visit study nurse 3 times in study period (at GW 24-28 and GW 35-37 and 3 months postpartum). Both groups also receive regular antenatal care in maternity clinics and hospitals. Maternal measurements at enrollment, and at 35-37 GW (both groups): - Laboratory tests: fp-gluc, HbA1c, fp-insu, lipids, hs-CRP - Fingertips glucose values from glucose meter (belong to normal antenatal care) - Fasting blood samples for future analyses - Weight, height, blood pressure (from the antenatal registry and study visits) - Questionnaires: background (only at enrollment), diet (food frequency questionnaire), depression (EPDS), motivation (TSRQ+PCS), quality of life (15D) - Physical activity and sedentary behavior with the hip-worn triaxial accelerometer (UKK RM 42) - Physical activity and heart rate with Firstbeat Bodyguard Measurements at Birth: - Cord blood sample - Placental weight - Offspring birthweight, height, body composition (PEA POD Cosmed®) Maternal measurements at 3 months postpartum: - Laboratory tests: fp-gluc, HbA1c, fp-insu, lipids, hs-CRP - fp-gluc, 2h postprandial value, as measured during oral glucose tolerance test (OGTT) - Fasting blood samples for future analyses - Firstbeat Bodyguard 2 measurement (3 days) - Depression questionnaire (EPDS) - Diet questionnaire (FFQ) Protocol only for the intervention group - eMOM GDM application: use: 1 application week + 3 normal care weeks repeatedly until delivery The application includes: 1. continuous glucose monitor (CGM) - fingertips glucose calibration according to CGM protocol (twice per day with Medtronic) 2. diet (digital food tracker) - 3 days during one application week - For ensuring the quality of food record a researcher will phone interview the participant based on her recordings. This is done after each recording period. 3. heartrate, stress and physical activity with the wrist-worn activity tracker (Vivosmart 3) 4. weight measured once a week Data from the sensors - Data from users' input to the application - Technology acceptance questionnaire (UTAUT) after every application week - Usability questionnaire, after four weeks usage of the eMOM GDM application - Semi-structured interview ;
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