Table 3 Findings from the eHealth studies
Author Year published Country | Study design and GDM definition | Aim of study | Population | Intervention | Outcomes measured | Key findings |
|---|---|---|---|---|---|---|
- Kim et al. [37] - 2021 - South Korea | - Quasi-experimental study - Exact diagnostic not specified, only stated that it is based on the result of oral glucose tolerance test between gestational weeks 24 and 28 | - Developing and evaluating the efficacy of a self-management mobile virtual reality program for preventing T2DM in women with recent GDM | - 128 women with recent GDM and no visual, auditory or active disabilities - Int.: 64. Con.: 64 - Control group not randomly assigned but selected after completing baseline measures for intervention group by matching for age, birth experience, type of birth, family history of T2DM, and breastfeeding status -5.4% patient withdrawal | - Mobile virtual reality program with diet and exercise modules, laughter therapy, and neonatal first aid - Control: written educational material - Follow-up: 12 weeks | - Body weight, body fat, fasting glucose, and HbA1c - Diabetes knowledge score - Dietary habits - Health promoting lifestyle score - Parenting stress | - Significant differences between the groups for all four physiological variables, as well as dietary habits and health promoting lifestyle score - No statistically significant differences for diabetes knowledge or parental stress |
- Lim et al. [38] - 2021 - Singapore | - RCT - 2013 WHO/IADPSG criteria | - Examine the effectiveness of a smartphone app for restoring target weight postpartum in women with recent GDM | - 200 women with recent GDM - Int.: 101.Con.: 99 - 9% lost to follow-up | - Smartphone app where participants could log weight, meals, activity and interact with health care professionals - Control group: standard care, with dietary advice and OGTT 6 weeks postpartum and further follow-up based on results - Follow-up: 4 months | - Primary: attainment of target weight 4 months postpartum (return to first trimester weight if BMI ≤ 23, or a minimum of 5% weight loss from first trimester weight if BMI ≥ 23 - Secondary: HbA1c, lipid profiles and other biomarkers, blood pressure, absolute weight loss, self-report calorie intake, health behavior, and emotional distress scores | - No significant group differences for primary outcome nor for serum biomarkers - Self-reported calorie intake lower in intervention group, and higher health behavior score, but also higher level of emotional stress |
- Potzel et al. [35] - 2022 - Germany | - RCT - Validated diagnosis of GDM according to German guidelines from 2014 (equivalent to 2013 WHO criteria) | - To evaluate the acceptability and effectiveness in improving CVD risk factors in women with recent GDM | - 66 women with GDM in last 3–18 months - Int.: 33. Con.: 33. - 18.2% drop-out | - iPhone app with modules on mental and emotional habits, physical activity, nutrition, and sleep. Possibilities for interaction with health care providers. Control: standard care (leaflet with lifestyle advice for preventing diabetes) - Follow-up: 6 months | - Primary: proportion of participants achieving ≥ 3 out of 5 Diabetes Prevention Program goals regarding physical activity, fiber and fat intake, and weight reduction/maintenance - Secondary: glucose levels, insulin sensitivity, oxygen uptake, body fat, and psychosocial indices. Patients also rated app acceptability | - No significant group differences for primary or secondary outcomes - 22 vs 11% in intervention and control group achieving primary outcome, but not statistically significant (p = 0.20) - App was well accepted |
- Peacock et al. [36] - 2015 - Australia | - RCT - Not specified | - Developing a program to support behavior changes in order to delay or prevent T2DM in women with a history of GDM and BMI > 25 | - 31 women with a GDM diagnosis within the previous 6 to 24 months - Int.: 16. Con.: 15 - 31% and 20% drop-out in intervention and control group respectively | - Pedometer program linked to web-based program where steps were logged and weekly goals generated. Also, 4 weeks nutrition coaching workshop - Control: “wait-list group,” offered nutrition workshop after end of follow-up Follow-up: 3 months | - Primary: weight loss - Secondary: waist/hip circumference, diet quality, insulin sensitivity, body composition, physical activity, self-efficacy in eating behaviors | - Significant difference in weight loss: − 2.5 kg (1.4 SD) vs 0.0 kg (2.3 SD), p = 0.002 - For the secondary outcomes, there were significantly better results in intervention group for hip and waist circumference and self-efficacy in eating behaviors |