An Exercise Intervention to Prevent Gestational Diabetes
Condition: Gestational Diabetes
MeSH terms: Diabetes, Gestational
Study type: Interventional

Summary: 
      Women diagnosed with gestational diabetes mellitus (GDM) are at substantially increased risk
      of developing type 2 diabetes and obesity, currently at epidemic rates in the United States.
      GDM, therefore, identifies a population of women at high risk of developing type 2 diabetes
      and thus provides an excellent opportunity to intervene years before the development of this
      disorder. It is well recognized that acute as well as chronic physical activity reduce
      fasting plasma glucose as well as improve glucose tolerance in type 2 diabetes. Recent
      studies have suggested that women with higher levels of physical activity have reduced risk
      of GDM. Therefore, we will test the hypothesis that an exercise intervention is an effective
      tool for preventing GDM among women with a history of GDM.
    

Detailed description: 
      The primary goals of the application are to investigate the effects of a
      motivationally-tailored, individually targeted 12-wk physical activity intervention on 1)
      risk of GDM in women at high risk of the condition, 2) serum biomarkers associated with
      insulin resistance, 3) and the adoption and maintenance of exercise during pregnancy.
      Secondary goals are to investigate the impact of the intervention on gestational weight gain
      and selected birth outcomes. The overall goal of the intervention is to encourage pregnant
      women to achieve the American College of Obstetricians and Gynecologists (ACOG) Guidelines
      for physical activity during pregnancy (30 minutes or more of moderate- intensity activity on
      most days of the week) through increasing walking and developing a more active lifestyle. The
      intervention draws from the theory of Stages of Motivational Readiness for Change and Social
      Cognitive Theory constructs for physical activity behavior and will take into account the
      specific social, cultural, economic, and physical environmental challenges faced by women of
      diverse socioeconomic and ethnic backgrounds. The application is innovative in being the
      first, to our knowledge, to test a physical activity intervention designed to prevent GDM
      among high risk women. The intervention protocol can readily be translated into clinical
      practice in underserved and minority populations.
    

Intervention name(s): Physical activity; Heath & Wellness
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Individually Tailored (IT) Exercise Intervention This intervention is designed to increase the amount of physical activity incorporated into the daily lifestyle of pregnant women, primarily through increased walking, with the ultimate goal of achieving the American College of Obstetricians and Gynecologists (ACOG) exercise goals for pregnant women. These goals are the same as the Surgeon General's Guidelines for physical activity for nonpregnant individuals (30 minutes or more or moderate activity on most days of the week).The intervention includes: 1) individually tailored print-based materials (i.e., individually-tailored reports and stage-matched manuals), 2) self-monitoring materials, and 3) goal setting.; The comparison intervention consists of a series of informational booklets published by the American College of Obstetricians and Gynecologists on general issues related to health and wellness during pregnancy. These include alcohol and drug use during pregnancy, easing back pain, as well as the Pregnancy Fitness brochure on the safety of exercise during pregnancy. These booklets are selected to represent high-quality, standard, low-cost, self-help material currently available to the public.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: gestational diabetes; physical activity; behavior change; glucose tolerance; pregnancy