Baby Steps - Walking Away from Gestational Diabetes

ISRCTN ISRCTN17299860
DOI https://doi.org/10.1186/ISRCTN17299860
IRAS number 210608
Secondary identifying numbers 32982, IRAS 210608
Submission date
20/03/2017
Registration date
05/04/2017
Last edited
29/08/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Up to 15% of pregnant women develop a temporary type of diabetes during pregnancy called gestational diabetes mellitus (GDM). In GDM, women develop high blood sugar levels as the body is unable to produce enough insulin (a hormone that helps convert sugar into stored energy). GDM is associated with increased risks for mother and baby including increased risk of later life diabetes for the mother. Research shows that structured education programmes can help people to lower their risk of developing cardiovascular disease (disease of the heart and blood vessels) and so can be beneficial for a patient’s future health and for health care professionals. The aim of the study is to develop and implement face-to-face and online lifestyle education programme to meet the needs of women with a history of gestational diabetes.

Who can participate?
Women who are up to 36 weeks into their pregnancy who have been diagnosed with gestational diabetes.

What does the study involve?
All participants attend an initial study visit where blood pressure, body measurements and blood samples are taken to measure cholesterol and to find out whether they have diabetes or are likely to develop type 2 diabetes, as well as completing questionnaires about diet and exercise. Participants are then randomly allocated to one of two groups. Those in the first group are given an information leaflet after the birth of the baby. Those in the second group attend two three-hour education sessions spaced approximately two weeks apart. These participants are also given access to an interactive website, which encourages healthy lifestyle choices, such as through diet and exercise advice. All women are asked to wear an activity monitor for eight days before, during (six months) and after the study (12 months) to record their activity levels. At the start of the study and then again after six and 12 months participants complete a number of questionnaires to measure their wellbeing and provide blood samples to assess blood sugar and cholesterol.

What are the possible benefits and risks of participating?
All women taking part will benefit from a free health assessment and physical activity advice as well as information on general fitness levels. There is a small risk of pain or bruising when blood samples are taken.

Where is the study run from?
1. Leicester General Hospital (UK)
2. Leicester Royal Infirmary (UK)
3. George Eliot Hospital NHS Trust (UK)

When is the study starting and how long is it expected to run for?
March 2015 to December 2018

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
Helen Dallosso
helen.dalloss@uhl-tr.nhs.uk

Contact information

Ms Helen Dallosso
Public

Leicester Diabetes Centre
Leicester General Hospital
Leicester
LE5 4PR
United Kingdom

Phone +44 (0)116 2584738
Email helen.dalloss@uhl-tr.nhs.uk

Study information

Study designRandomised; Interventional; Design type: Prevention, Complex Intervention
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet ISRCTN17299860_PIS_03Jan17_V3_full.docx
Scientific titleA randomised controlled trial to investigate the effect of a structured education programme on women who have had gestational diabetes and are at risk of developing type 2 diabetes
Study acronymBABY STEPS
Study objectivesThe aim of the study is to implement and evaluate a structured education programme with additional support (wrist-worn activity monitor linked to an interactive website).
Ethics approval(s)East Midlands- Derby Research Ethics Committee, 01/03/2017, ref: 16/EM/0488
Health condition(s) or problem(s) studiedSpecialty: Reproductive health and childbirth, Primary sub-specialty: Maternal/ Fetal medicine; UKCRC code/ Disease: Reproductive Health and Childbirth/ Other maternal disorders predominantly related to pregnancy
InterventionAn invitation pack (letter, short information leaflet and prepaid envelope) will be sent to patients identified as eligible on a register maintained by the maternity department. Expressions of interest will be sent to the research team who will contact the responder, check their eligibility and if the responder is interested in taking part they will book them to attend a recruitment clinic. The potential participant will be sent a full Patient Information Leaflet to read before they attend. At the recruitment clinic written informed consent will be obtained by a trained member of the research team after which the various outcome measures will be made and the participant will be asked to complete a questionnaire. The participant will be given an accelerometer and asked to wear it continuously for 8 days and then return it by post to the research team.

After the baseline clinic participants will be randomised using a block design by an independent researcher. Randomisation will be stratified by age (<30; ≥30) and ethnicity (White European; other) and will dictate the pathway each participant will take in the study (control group or intervention group). The stratified randomisation lists will be prepared by an independent statistician, for allocation and concealment. A researcher independent of the study team will follow a standard operating procedure to reveal the randomisation as requested.

Intervention participants will attend the Baby Steps Programme and control participants will be sent an information leaflet about the prevention of diabetes.

The Baby Steps Programme comprises two group education sessions (3 hours each and one week apart) which are delivered by two trained Facilitators. Participants attending will be given a Fit-Bit to help them monitor their physical activity level during the study period and will be given access to a website containing information on how to attain a healthy lifestyle and be more active.

Follow-up data will be collected at 6 months and 12 months. At 6 months the participants will be sent an accelerometer to wear for 8 days and a questionnaire to complete. Both will returned to the research team in a prepaid envelope. At 12 months the participants will be contacted and booked to attend a follow-up clinic. The baseline measures will be repeated and participants will be given an accelerometer to wear for 8 days.
Intervention typeOther
Primary outcome measurePhysical activity is measured using an accelerometer, worn for 8 days at baseline, 6 months and 12 months.
Secondary outcome measures1. Lipid profile (high density lipoproteins, low density lipoproteins, triglycerides, total cholesterol) is measured using a venous blood sample at baseline and 12 months
2. Glycated haemoglobin (HbA1c) is measured is measured using a venous blood sample at baseline and 12 months
3. Resting heart rate and blood pressure are measured using an automated BP device at baseline and 12 months
4. Body mass, BMI, waist circumference and hip circumference are measured using a height scale, weight scales, and tape measure at baseline and 12 months
5. Self-reported physical activity is measured using the validated Recent Physical Activity Questionnaire (RPAQ) at baseline, 6 and 12 months
6. Health related quality of Life is measured using the EQ-5D-5L questionnaire at baseline, 6 and 12 months
7. Anxiety and Depression is measured using the Hospital Anxiety and Depression Scale (HADS) at baseline, 6 and 12 months
8. Exercise self efficacy is measured using the Jenkins Self-Efficacy for Exercise Expectations Scale at baseline, 6 and 12 months
9. Fruit and vegetable intake is measured using the 5-A-Day Consumption and Evaluation Tool (FACET) at baseline, 6 and 12 months
Overall study start date13/03/2015
Completion date31/12/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participantsPlanned Sample Size: 290; UK Sample Size: 290
Total final enrolment293
Key inclusion criteria1. A diagnosis of gestational diabetes in most recent pregnancy
2. Up to 36 months postnatal
3. Willing and able to attend the education sessions and clinic
4. Willing and able to give informed consent
5. Able to speak and read English to a sufficient level to understand the study and education programme
6. Telephone access
7. Aged 18 years and older
Key exclusion criteria1. Currently has gestational diabetes
2. Currently pregnant at present
3. Type 1 or type 2 diabetes
4. Cancer (not in remission)
5. Severe diagnosed mental illness (e.g. Schizophrenia, bipolar)
6. Previous surgical or medical intervention to treat obesity
7. No access to internet
8. Does not have capacity to give informed consent
9. Participants who are currently participating or who have participated in another clinical intervention study in the previous 12 weeks
10. Unable to speak and read English to a sufficient level to understand the study and education programme
Date of first enrolment01/05/2017
Date of final enrolment30/06/2018

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centres

Leicester General Hospital
Gwendolen Road
Leicester
LE5 4PW
United Kingdom
Leicester Royal Infirmary
Infirmary Square
Leicester
LE1 5WW
United Kingdom
George Eliot Hospital NHS Trust
College Street
Nuneaton
CV10 7DJ
United Kingdom

Sponsor information

University of Leicester
University/education

Academic Unit
Leicester General Hospital
Gwendolen Road
Leicester
LE5 4PW
England
United Kingdom

Phone +44 116 2584393
Email dd78@le.ac.uk
ROR logo "ROR" https://ror.org/04h699437

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date01/09/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe findings of the research will be presented at local and national conferences and will be submitted for publication in relevant peer-reviewed journal.
IPD sharing planThere will not be open access to the data online. However please contact the PI (Prof Kamlesh Khunti, kk22@leicester.ac.uk) if you are interested in accessing the data for further analysis.
Please provide a summary of the analysis plans you have and a list of the data you would require. All applications will be considered.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet version V3 03/01/2017 05/04/2017 No Yes
Participant information sheet version V3 03/01/2017 05/04/2017 No Yes
Protocol article protocol 12/12/2018 Yes No
Statistical Analysis Plan 30/09/2019 24/04/2020 No No
Other publications Participants' experiences of using the app 05/08/2021 31/10/2022 Yes No
Results article results 16/04/2023 31/05/2023 Yes No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN17299860_PIS_03Jan17_V3_full.docx
Uploaded 05/04/2017
ISRCTN17299860_PIS_03Jan17_V3_short.docx
Uploaded 05/04/2017
ISRCTN17299860_SAP_V 1.0_30Sep19.pdf
Uploaded 24/04/2020

Editorial Notes

29/08/2023: The following changes have been made:
1. The IPD sharing plan was changed from "The data sharing plans for the current study are unknown and will be made available at a later date." to "There will not be open access to the data online. However please contact the PI (Prof Kamlesh Khunti, kk22@leicester.ac.uk) if you are interested in accessing the data for further analysis. Please provide a summary of the analysis plans you have and a list of the data you would require. All applications will be considered." and the IPD sharing summary updated accordingly.
2. The IRAS number has been added.
31/05/2023: Publication reference added.
31/10/2022: Publication reference added.
27/04/2020: The following changes were made to the trial record:
1. The intention to publish date was changed from 31/12/2019 to 01/09/2020.
2. IPD sharing statement added.
24/04/2020: Uploaded statistical analysis plan, contact details updated.
17/12/2018: Publication reference added.
22/01/2018: The recruitment end date was changed from 31/12/2017 to 30/06/2018.