A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial

BackgroundGestational Diabetes Mellitus (GDM) exposes women to future risk of Type 2 Diabetes. Previous studies focused on diet and physical activity, less emphasis was given to tackle intertwined risk factors such as sleep and stress. Knowledge remains scarce in multi-ethnic Asian communities. This...

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Main Authors: Seaw Jia Liew, Chun Siong Soon, Yu Chung Chooi, Mya Thway Tint, Johan Gunnar Eriksson
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-09-01
Series:Frontiers in Clinical Diabetes and Healthcare
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1251411/full
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author Seaw Jia Liew
Chun Siong Soon
Yu Chung Chooi
Mya Thway Tint
Mya Thway Tint
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
author_facet Seaw Jia Liew
Chun Siong Soon
Yu Chung Chooi
Mya Thway Tint
Mya Thway Tint
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
author_sort Seaw Jia Liew
collection DOAJ
description BackgroundGestational Diabetes Mellitus (GDM) exposes women to future risk of Type 2 Diabetes. Previous studies focused on diet and physical activity, less emphasis was given to tackle intertwined risk factors such as sleep and stress. Knowledge remains scarce in multi-ethnic Asian communities. This study explored the: (1) feasibility of a holistic digital intervention on improving diet, physical activity (PA), sleep and stress of Asian women with a history of GDM, and (2) preliminary efficacy of the holistic intervention on women’s physical and mental well-being via a pilot randomized controlled trial.MethodsFemale volunteers with a history of GDM but without pre-existing diabetes were recruited from multi-ethnic Singaporean community. Each eligible woman was given a self-monitoring opportunity using Oura Ring that provided daily feedback on step counts, PA, sleep and bedtime heart rate. Intervention group additionally received personalized recommendations aimed to reinforce healthy behaviors holistically (diet, PA, sleep and stress). Dietary intake was evaluated by a research dietitian, while step counts, PA, sleep and bedtime heart rate were evaluated by health coaches based on Oura Ring data. Perceived physical and mental health and well-being were self-reported. Clinical outcomes included glycemic status determined by HbA1c and OGTT tests, body mass index, blood pressures and lipid profile.ResultsOf 196 women from the community, 72 women completed diabetes screening, 61 women were eligible and 56 women completed the study. The 56 completers had mean age of 35.8 ± 3.7 years, predominantly Chinese, majority had their first GDM diagnosed at least 2 years ago and had two GDM-affected pregnancies. After intervention period, more women in the Intervention group achieved at least 8,000 steps/day and had at least 6 hours of sleep per night. Noticeable reduction of added sugar in their food and beverages were observed after the dietary intervention. Changes in body weight and mental well-being were observed but group differences were not statistically significant.ConclusionsThe holistic approach appeared feasible for personalizing lifestyle recommendations to promote physical and mental well-being among women with a history of GDM. Larger studies with sufficient assessment timepoints and follow-up duration are warranted to improve the evaluation of intervention effects on clinical outcomes.Clinical trial registration numberhttps://clinicaltrials.gov/show/NCT05512871, NCT05512871.
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spelling doaj.art-e8fda002a9c44188b428f7138678a2812023-09-29T04:26:31ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162023-09-01410.3389/fcdhc.2023.12514111251411A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trialSeaw Jia Liew0Chun Siong Soon1Yu Chung Chooi2Mya Thway Tint3Mya Thway Tint4Johan Gunnar Eriksson5Johan Gunnar Eriksson6Johan Gunnar Eriksson7Johan Gunnar Eriksson8Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeCentre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeSingapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, SingaporeHuman Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeSingapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, SingaporeHuman Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeSingapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, SingaporeDepartment of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeFolkhälsan Research Center, Helsinki, FinlandBackgroundGestational Diabetes Mellitus (GDM) exposes women to future risk of Type 2 Diabetes. Previous studies focused on diet and physical activity, less emphasis was given to tackle intertwined risk factors such as sleep and stress. Knowledge remains scarce in multi-ethnic Asian communities. This study explored the: (1) feasibility of a holistic digital intervention on improving diet, physical activity (PA), sleep and stress of Asian women with a history of GDM, and (2) preliminary efficacy of the holistic intervention on women’s physical and mental well-being via a pilot randomized controlled trial.MethodsFemale volunteers with a history of GDM but without pre-existing diabetes were recruited from multi-ethnic Singaporean community. Each eligible woman was given a self-monitoring opportunity using Oura Ring that provided daily feedback on step counts, PA, sleep and bedtime heart rate. Intervention group additionally received personalized recommendations aimed to reinforce healthy behaviors holistically (diet, PA, sleep and stress). Dietary intake was evaluated by a research dietitian, while step counts, PA, sleep and bedtime heart rate were evaluated by health coaches based on Oura Ring data. Perceived physical and mental health and well-being were self-reported. Clinical outcomes included glycemic status determined by HbA1c and OGTT tests, body mass index, blood pressures and lipid profile.ResultsOf 196 women from the community, 72 women completed diabetes screening, 61 women were eligible and 56 women completed the study. The 56 completers had mean age of 35.8 ± 3.7 years, predominantly Chinese, majority had their first GDM diagnosed at least 2 years ago and had two GDM-affected pregnancies. After intervention period, more women in the Intervention group achieved at least 8,000 steps/day and had at least 6 hours of sleep per night. Noticeable reduction of added sugar in their food and beverages were observed after the dietary intervention. Changes in body weight and mental well-being were observed but group differences were not statistically significant.ConclusionsThe holistic approach appeared feasible for personalizing lifestyle recommendations to promote physical and mental well-being among women with a history of GDM. Larger studies with sufficient assessment timepoints and follow-up duration are warranted to improve the evaluation of intervention effects on clinical outcomes.Clinical trial registration numberhttps://clinicaltrials.gov/show/NCT05512871, NCT05512871.https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1251411/fulldiabetesgestational diabetes mellitusfeasibilitypilotrandomized controlled trialholistic
spellingShingle Seaw Jia Liew
Chun Siong Soon
Yu Chung Chooi
Mya Thway Tint
Mya Thway Tint
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
Johan Gunnar Eriksson
A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
Frontiers in Clinical Diabetes and Healthcare
diabetes
gestational diabetes mellitus
feasibility
pilot
randomized controlled trial
holistic
title A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
title_full A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
title_fullStr A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
title_full_unstemmed A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
title_short A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial
title_sort holistic approach to preventing type 2 diabetes in asian women with a history of gestational diabetes mellitus a feasibility study and pilot randomized controlled trial
topic diabetes
gestational diabetes mellitus
feasibility
pilot
randomized controlled trial
holistic
url https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1251411/full
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