Evidence mapPaperPMID 38879496Full record

ArticlePilot and feasibility studies2024

Conducting a diabetes mellitus prevention trial in women with GDM in Pakistan: a feasibility study.

Romaina Iqbal, Sabahat Naz, Sana Sheikh, Rahat Qureshi, Shereen Bhutta, Haleema Yasmeen, Iqbal Azam, Paramjit Gill

Abstract read
In one paragraph

Article in Pilot and feasibility studies, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Romaina IqbalCommunity Health Sciences Department, The Aga Khan University, Karachi, Pakistan. romaina.iqbal@aku.edu.ORCID http://orcid.org/0000-0002-5364-4366
Sabahat NazCommunity Health Sciences Department, The Aga Khan University, Karachi, Pakistan.
Sana SheikhDepartment of Medicine, The Aga Khan University, Karachi, Pakistan.
Rahat QureshiDepartment of Obstetrics and Gynecology, The Aga Khan University, Karachi, Pakistan.
Shereen BhuttaJinnah Postgraduate Medical Center, Karachi, Pakistan.
Haleema YasmeenJinnah Postgraduate Medical Center, Karachi, Pakistan.
Iqbal AzamCommunity Health Sciences Department, The Aga Khan University, Karachi, Pakistan.
Paramjit GillDivision of Health Sciences, University of Warwick, Coventry, UK.

Funding

Medical Research Council, UK MR/M022048/1
6 · The paper itself

Abstract

backgroundWomen with gestational diabetes mellitus (GDM) are at a greater risk of developing type 2 diabetes mellitus (T2DM) than women without GDM. Despite this elevated risk, few trials on the prevention of T2DM among South Asian women with GDM have been reported. Therefore, this study aimed to assess the feasibility of conducting a diabetes prevention program on women with a history of GDM to inform the development of a contextually relevant definitive trial.

methodsUsing a randomized controlled trial, women with GDM (n = 180) who delivered at the study hospitals (one public and one private teaching hospital, Karachi) with fasting blood glucose levels < 120 mg/dl at 6 weeks postpartum were randomized to the intervention (n = 88) or control arms (n = 92). Women in the intervention group received individualized home-based educational sessions from trained community health workers at 0, 1, 3, 6, and 9 months. In addition, they received short text messages, prerecorded messages, and printed educational material (calendars and pamphlets) for reinforcement. The intervention was centered on equipping women with knowledge, skills, and confidence to eat a healthy diet rich in fruits, vegetables, and low-fat dairy products and perform regular physical activity based on walking and household chores to reduce weight (up to 5% of their initial body weight). Women in the control arm received standard care. The feasibility outcomes of the study included screening, recruitment, and retention rates and in-depth interviews at 6 months post-intervention to explore women's experiences with the intervention. Descriptive analysis and thematic analysis were performed.

resultsOf the 324 women screened during the antenatal care visits and after delivery, 255 (78.7%) were contactable 6 weeks postpartum, and 180 (70.6%) were eligible and randomized to intervention (n = 88) and control (n = 92) groups. Loss to follow-up in the intervention and control arms was 22.7% (n = 20/88) and 18.5% (n = 17/92), respectively. Women expressed satisfaction with home-based counseling and follow-up visits, text message reminders, and printed material in the form of a calendar through our qualitative interviews.

conclusionsHome-based lifestyle modification intervention augmented with text messages and printed material is feasible. However, to evaluate the intervention's effectiveness, a larger trial is warranted to assess its long-term impact on diabetes prevention.

trial registrationISRCTN, ISRCTN11387113 . Registered 5 December 2017-retrospectively registered.

Indexed as

Gestational diabetes mellitusLifestyle modificationPakistanPrimary prevention

Identifiers

PMID38879496
PMCPMC11179295

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.