Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 5, 2020
Date Accepted: Jan 9, 2021
SmartPhone Application to Restore Optimal Weight (SPAROW) for Women with Recent Gestational Diabetes Mellitus: A Randomized Controlled Trial
ABSTRACT
Background:
Women with a history of gestational diabetes mellitus (GDM) are at increased risk of developing type 2 diabetes (T2DM). Lifestyle interventions aimed at postpartum weight loss to reduce T2DM risk have been reported, but poor compliance remains a barrier. Smartphone-based interventions may improve compliance, but data on its use in women with recent GDM is limited.
Objective:
This trial aims to investigate the efficacy of a smartphone app (APP) to restore optimal weight following delivery in a population with a high prevalence of GDM.
Methods:
In this open-label randomized controlled trial, 200 women with GDM were randomized to receive the intervention or standard care following delivery. The intervention is an interactive APP for weight loss. The primary outcome was achievement of optimal weight (defined as restoration of first trimester weight if first trimester BMI ≤23kg/m2 or weight loss of at least 5% from first trimester weight if first trimester BMI >23kg/m2) at 4-months postpartum. Secondary outcome measures included absolute weight loss, serum metabolic markers, nutritional intake, and health education and quality of life assessments.
Results:
Forty percent of women in the intervention group achieved optimal weight at 4 months post-delivery compared to 32.2% in the control group (p=0.273). The mean weight difference in the intervention group was not significantly different to control [1.05kg (95%CI -2.24, 0.14) p=0.084). Compared with control, women in the intervention group reported significantly reduced caloric intake at 4 months post-delivery delivery (p<0.001) and higher health-directed behavior scores (p=0.045). The intervention group also reported increased emotional distress scores (p=0.010).
Conclusions:
This trial suggests that an APP is an effective method for achieving healthy weight in women with GDM following delivery. A larger study with increased statistical power and longer term follow-up of cardiometabolic outcomes is required to support widespread implementation of the APP. Clinical Trial: The trial obtained ethics approval from the Domain Specific Review Board and was registered under clinicaltrials.gov (identifier: NCT03324737).
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