OBJECTIVE Most women with previous gestational diabetes mellitus (GDM) who are eligible for diabetes prevention programs are not referred and do not participate. We evaluated a tailored approach for program engagement in women with previous GDM. RESEARCH DESIGN AND METHODS This feasibility study engaged women with previous GDM to discuss type 2 diabetes risk and select a program aligned with individual priorities. Seven lifestyle change programs, including the National Diabetes Prevention Program (NDPP) and two NDPP adaptations, were offered free of charge. We measured program selection and completion and clinical and psychosocial outcomes at baseline, 6 months (T1), and 12 months (T2). Descriptive statistics and paired t tests assessed changes over time. RESULTS We consented 116 women (age 35.2 ± 5.6 years; 58.7% White; 46.8% college degree). Ninety-two participants were included in data analysis after exclusions because of pregnancy (n = 9), baseline BMI 25 (n = 11), baseline HbA1c ≥6.5 (n = 3), and illness (n = 1). Almost half of participants selected a commercial weight loss program (WW International, 41%), followed by a virtual NDPP (HabitNu, 22%), individual health coaching (11%), an in-person family-based NDPP adaptation (11%), a dietitian consult (9%), a clinic-based group program (5%), and an in-person NDPP (1%). Program completion was over 60%. Clinical and psychosocial outcomes were stable from baseline to T2. CONCLUSIONS Lifestyle change program engagement was feasible in women with previous GDM, even during the coronavirus disease 2019 pandemic. Using informed decision-making strategies and a choice of lifestyle change programs to meet the unique priorities of women with previous GDM may optimize engagement.
Pike et al. (Tue,) studied this question.
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