GDM Clinical Trial
Official title:
Chrono Nutrition Intervention Program in Gestational Diabetes Mellitus
Working hypothesis and aims:
To asses Chrono Biological factors during the third trimester of gestational diabetes
melittus (GDM) with birth weight and related complications. The investigators hypothesize
that participants with GDM pregnancies with higher Chrono Biologocal status will be ended
with higher birth weight compared to participants with GDM pregnancies with lower status. In
addition, the investigators hypothesize that the Chrono Nutritional intervention program
will contribute to the reduction of the rate of birth weight above percentile 90 compared
with the participants with GDM in the control group.
Background: Many studies have linked pre-pregnancy obesity and the metabolic syndrome, with
an increased risk of developing gestational diabetes mellitus (GDM). These factors are
associate with increased risk of newborn obesity, insulin resistance and diabetes. Recently,
studies have shown that the "Chrono-Biological" (CB) aspects need to be considered in this
context. These factors are related to endogenous circadian clocks, which regulate many body
functions depending upon cycle of light and darkness during a day of almost 24 hours. By
tracks daily fluctuations in heart rate, blood pressure, hormone secretion and control of a
variety of metabolic pathways. Factors that can affect the setting of the circadian clock
may include; Change dark and light hours, consumptions of certain nutrients during the day
and more.
Chronic rhythm disruption associated with the development of obesity, diabetes, and more.
Factors such as "chrono-nutrition" (CN) have a significant impact on variations in circadian
rhythms includes: meals program schedule, glucose, saturated fat, caffeine and alcohol
intake, and the ratio of macronutrients. Intervention studies in adults who are obese and
diabetes were able to reduce the impact of these disorders by changing the composition and
schedule of meals that lead to weight loss and diabetes control. Moreover, Insomnia during
pregnancy can be caused by disorders CB. Insomnia affects 30-40% of all pregnancies. Some
sleep disorders can be worsening by pregnancy, particularly overweight. Currently, routine
monitoring and treatment of women with GDM does not include screening for sleep disorders
and CN factors.
Working hypothesis and aims: To asses CB factors during the third trimester of participants
with GDM pregnancies with a weight of childbirth and related complications. The
investigators hypothesize that participants with GDM pregnancies with higher CB status will
be ended with higher birth weight compared to participants with GDM pregnancies with a lower
status.
In addition, the investigators assume that the CN intervention program will contribute to
reducing the rate of birth weight above the 90 percentile compared to control group.
Methods: In a prospective cohort study, n= 280, The investigators will review the obstetric
outcomes and the impact of CB disorders and complications for mother and fetus, through
questionnaires. In a clinical trial n=100, The investigators will assess the effect of CN
intervention on birth weight in participants with GDM pregnancies.
Expected results: Based on the investigators preliminary research and literature, The
investigators expected that due to the increasing prevalence of obesity and sleep
disturbance among GDM pregnancies , and the feasibility of high interference CN factors in
pregnancy, Therefore, it is important to examine the impact of CB factors on maternal and
fetal.
The importance of the study: Since there is a high probability that GDM is exposed to the
interference of CB factors which are not monitored during GDM, this unique study, is of
great importance for understanding the potential impact of the CB factors on higher birth
weight rates.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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