Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Feb;44(2):456-463.
doi: 10.2337/dc20-1216. Epub 2020 Nov 12.

A Randomized Controlled Trial to Evaluate the Effects of a Smartphone Application-Based Lifestyle Coaching Program on Gestational Weight Gain, Glycemic Control, and Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus: The SMART-GDM Study

Tong Wei Yew  1   2 , Claudia Chi  3 , Shiao-Yng Chan  3   4 , Rob M van Dam  5 , Clare Whitton  5 , Chang Siang Lim  5 , Pin Sym Foong  5 , Winni Fransisca  2 , Chieu Leng Teoh  6 , Jeannie Chen  6 , Su Tin Ho-Lim  6 , Su Lin Lim  7 , Kai Wen Ong  8 , Peck-Hoon Ong  9 , Bee Choo Tai  5 , E Shyong Tai  10   2   5
Affiliations
Randomized Controlled Trial

A Randomized Controlled Trial to Evaluate the Effects of a Smartphone Application-Based Lifestyle Coaching Program on Gestational Weight Gain, Glycemic Control, and Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus: The SMART-GDM Study

Tong Wei Yew et al. Diabetes Care. 2021 Feb.

Abstract

Objective: SMART-GDM examined whether Habits-GDM, a smartphone application (app) coaching program, can prevent excessive gestational weight gain (EGWG) and improve glycemic control and maternal and neonatal outcomes in gestational diabetes mellitus (GDM).

Research design and methods: In this randomized controlled trial, women diagnosed with GDM between 12 and 30 weeks were randomly assigned to usual care (control) or to additional support from Habits-GDM that integrated dietary, physical activity, weight, and glucose monitoring (intervention). The primary outcome was the proportion of participants with EGWG. Secondary outcomes included absolute gestational weight gain (GWG), glycemic control, and maternal, delivery, and neonatal outcomes.

Results: In total, 340 women were randomized (170 intervention, 170 control; mean ± SD age 32.0 ± 4.2 years; mean BMI 25.6 ± 5.6 kg/m2). There were no statistically significant differences in the proportions of women with EGWG, absolute GWG, or maternal and delivery outcomes between experimental groups. Average glucose readings were lower in the intervention group (mean difference -0.15 mmol/L [95% CI -0.26; -0.03], P = 0.011) as were the proportions of glucose above targets (premeal: 17.9% vs. 23.3%, odds ratio 0.68 [95% CI 0.53; 0.87], P = 0.003; 2-h postmeal: 19.9% vs. 50%, 0.54 [0.42; 0.70], P < 0.001). When regarded as a composite (although not prespecified), the overall neonatal complications (including birth trauma, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress, neonatal intensive care unit admission, and perinatal death) were significantly lower in the intervention group (38.1% vs. 53.7%, 0.53 [0.34; 0.84], P = 0.006).

Conclusions: When added to usual care, Habits-GDM resulted in better maternal glycemic control and composite neonatal outcomes (nonprespecified) but did not reduce EGWG among women with GDM.

Trial registration: ClinicalTrials.gov NCT03249896.

PubMed Disclaimer

Comment in

References

    1. Chong YS, Cai S, Lin H, et al. .; GUSTO study group . Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study. BMC Pregnancy Childbirth 2014;14:345. - PMC - PubMed
    1. Yew TW, Khoo CM, Thai AC, Kale AS, Yong EL, Tai ES. The prevalence of gestational diabetes mellitus among Asian females is lower using the new 2013 World Health Organization diagnostic criteria. Endocr Pract 2014;20:1064–1069 - PubMed
    1. Perkins JM, Dunn JP, Jagasia SM. Perspectives in gestational diabetes mellitus: a review of screening, diagnosis, and treatment. Clin Diabetes 2007;25:57–62
    1. Horvath K, Koch K, Jeitler K, et al. . Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. BMJ 2010;340:c1395. - PMC - PubMed
    1. Kominiarek MA, Saade G, Mele L, et al. .; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network . Association between gestational weight gain and perinatal outcomes. Obstet Gynecol 2018;132:875–881 - PMC - PubMed

Publication types