Discussion
GDM, T2DM, Diabetes, prediabetes increase, weight loss, diabetes
GDM, GESTATIONAL DIABETES, DIABETES, DIABETES
This study protocol describes the planned methodology of the Gestational diabetes Risk Attenuation for New Diabetes (GRAND) study, a multi-center RCT that evaluates whether SDM can help women with a history of GDM and prediabetes increase weight loss and adoption of evidence-based strategies to lower their risk of incident diabetes. We will compare the proportion of participants (intervention vs. control) achieving ≥5% weight loss and taking up lifestyle change and/or metformin in a real-world setting. We will also assess whether SDM may result in lower rates of GDM in a subsequent pregnancy and estimate the costs related to implementing SDM intervention to help healthcare practices assess the resources they will need to implement a similar program.Given the increased lifetime risk of incident T2DM in women with a GDM history, engaging this population in evidence-based strategies for diabetes prevention is critical. This study presents a unique opportunity to address a vital area of unmet need in diabetes prevention for women with history of GDM, leveraging our health system infrastructure and our collaborative, multidisciplinary team with a strong record of accomplishment in diabetes prevention.