To mitigate the transgenerational risk of diabetes, research is needed to advance the prevention of gestational diabetes and to properly diagnose and treat it when it occurs. American Diabetes Association (ADA) research supports research projects that address these critical topics. For specific examples of projects currently funded by the ADA, see below.
Erika F. Werner, MD
Women & Infants Hospital of Rhode Island
Project: Assessing and avoiding barriers to post-partum glucose testing among women with gestational diabetes (GDM)
“I was drawn to obstetrics because pregnancy is one of the best screening tests for overall health. Pregnancy outcomes give us a window into the future health of women and the post-partum period gives an opportunity to change this future for the better. There is no better example of this principle than gestational diabetes. If we can appropriately intervene following a diagnosis of gestational diabetes, we can prevent up to 50% of future cases of diabetes in women.”
The Problem: Some women develop high blood sugar levels in pregnancy, a diagnosis known as GDM. A significant percentage of these women will have elevated blood sugars, prediabetes, even after pregnancy. Women with prediabetes are at high risk to develop type 2 diabetes unless they change their lifestyle and/or take medication. Therefore, testing women with GDM for prediabetes post-partum is the first step towards preventing type 2 diabetes. Unfortunately, most women with GDM never get tested for pre-diabetes and instead go on to develop type 2 diabetes in the years after delivery.
The Project: Dr. Werner’s project will determine how we can change post-partum care to better identify women with prediabetes and then intervene to reduce their diabetes risk. Three hundred women with GDM will receive routine care so that we can compare the women who return for post-partum glucose testing to those who do not return. Dr. Werner will compare individual characteristics, barriers to care and attitudes toward health care among the two groups. Additionally, Dr. Werner will determine if the test to determine prediabetes, normally given between 6 and 12 weeks after birth, can be given at 2 days post-birth while the mother is still in the hospital.
The Potential Outcome: The outcomes collected from this project will inform a re-purposing of post-partum care for women with GDM so that we can better prevent type 2 diabetes in a high-risk population.
Reena Oza-Frank, PhD
The Ohio Department of Health
Project: Practical approaches to postpartum weight loss after gestational diabetes (GDM)
“It is important to me to help build an evidence base to broaden public health policy to address the global priority of type 2 diabetes prevention. A healthy family starts with a healthy mother. By empowering women to be able to take the steps towards implementing a healthy lifestyle during the postpartum period, a health-promoting foundation can be created and extend to the family unit, reducing type 2 diabetes risk across generations.”
The Problem: GDM greatly increases risk for subsequent development of type 2 diabetes (T2D). This increased risk is compounded by excess weight retention, a common issue after pregnancy and a major risk factor for developing T2D. Thus, weight loss intervention is critical to prevent and/or delay T2D in these high-risk women and the weeks and months immediately after a GDM-complicated pregnancy present a unique window of opportunity for implementing an intervention. However, asking postpartum women to make lifestyle changes during a time consumed by competing demands has proven to be a major challenge in previous interventions.
The Project: Based on this problem, there is a critical need to test an intervention that addresses postpartum barriers to making lifestyle changes. Dr. Oza-Frank plans to test the effectiveness of a simple, novel, activity-boosting intervention on weight loss through 6 months postpartum among women with GDM. The intervention uses ankle weights (2.5 pounds [1.1 kg]) worn on each ankle during the usual daily activities (e.g., cleaning, cooking, childcare, etc.). Based on her previous work, Dr. Oza-Frank believes women with GDM will adopt an exercise intervention that requires minimal additional time outside of their daily activities.
The Potential Outcome: By adopting this intervention, women in the intervention could experience more, faster weight loss compared with women who were not in the intervention, reducing their long-term risk of T2D. If successful, this intervention program could then be broadly applied to women following a pregnancy with GDM.