- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01679210
Study of a Postpartum Diabetes Prevention Program for Hispanic Women
April 27, 2020 updated by: Lisa Chasan-Taber, University of Massachusetts, Amherst
Estudio PARTO: Proyecto pAra Reducir Diabetes Tipo dOs / Project Aiming to Reduce Type twO Diabetes
The overall goal of this randomized controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce risk factors for type 2 diabetes and cardiovascular disease among postpartum Hispanic women with a history of abnormal glucose tolerance during pregnancy.
Study Overview
Detailed Description
Specific aims are to evaluate the impact of the intervention on 1) postpartum weight loss, 2) biomarkers associated with insulin resistance (i.e., glucose, insulin, HbA1c, leptin, TNF-α, HOMA, AUCgluc, adiponectin), 3) other cardiovascular risk factors (i.e., blood lipids, blood pressure, CRP, fetuin-A, albumin-to-creatinine ratio), and 4) the adoption and maintenance of postpartum behaviors associated with weight loss and prevention of diabetes risk (i.e., physical activity, diet).
Eligible Hispanic women will be recruited after routine GDM screening and randomly assigned to a Lifestyle Intervention (n=150) or a Comparison Health and Wellness (control) intervention (n=150).
The intervention will be based on our efficacious exercise and dietary interventions for Hispanics (R01NR011295; WIC Common Pathways).
Multimodal contacts (i.e., in-person, telephone counseling, and mailed print-based materials) will be used to deliver the intervention from randomization (29 wks gestation) to 12 months postpartum.
Targets of the intervention are to achieve Institute of Medicine Guidelines for postpartum weight loss; American College of Obstetrician and Gynecologist guidelines for physical activity; and American Diabetes Association guidelines for diet.
The intervention draws from Social Cognitive Theory and the Transtheoretical Model and addresses the specific social, cultural, economic, and physical environmental challenges faced by underserved Hispanic women.
Measures of adherence will include the Pregnancy Physical Activity Questionnaire (PPAQ), accelerometers, and dietary recalls.
The project is a Renewal Application of R01 DK064902, a study of lifestyle risk factors for GDM in Hispanic women.
The proposed project builds upon the expertise of the investigative team in conducting randomized controlled trials of lifestyle interventions among Hispanic pregnant women (R01 DK074876; S3948 ASPH/CDC) and controlled trials of lifestyle interventions among low-income Hispanics with type 2 diabetes and pre-diabetes (R18 DK0658850; R18DK067549) and can readily be translated into clinical practice in underserved and minority populations.
Study Type
Interventional
Enrollment (Actual)
263
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Massachusetts
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Springfield, Massachusetts, United States, 01199
- Baystate Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 45 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Hispanic women with one or more glucose values during the diagnostic test meeting or exceeding the thresholds defined according to the American Diabetes Association
Exclusion Criteria:
- history of type 1 or type 2 diabetes, heart disease, or chronic renal disease
- contraindications to postpartum participation in moderate physical activity or a low-fat/high-fiber diet (e.g., Crohn's disease, ulcerative colitis)
- inability to read English or Spanish at a 6th grade level
- <18 or >45 yrs of age
- women carrying multiples
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Lifestyle Intervention
Stage-matched physical activity and diet intervention materials and health education.
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Stage-matched physical activity and diet intervention materials and health education.
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NO_INTERVENTION: Health and Wellness
HW served as the comparison group and received the same number of in-person sessions, telephone calls, and mailings at the same time points as LI.
Content was limited to general information available to the public from the ACOG and the American Academy of Pediatrics and did not mention exercise behavior change.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postpartum weight change
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
|
Postpartum weight change will be measured as the difference between weight at 6 or 12 mos postpartum and weight at delivery.
Weight will be measured on a digital scale.
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Percent of participants meeting postpartum weight goals
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Postpartum weight goals will be defined as weight change to prepregnancy weight if prepregnancy BMI was normal, or a 5% change towards prepregnancy weight if prepregnancy BMI was overweight/obese.
Weight will be measured on a digital scale.
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Fasting Glucose (FG)
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
|
Fasting Glucose (FG) will be measured enzymatically on the Roche P Modular system using Roche Diagnostics reagents (Indianapolis, IN)(mg/dL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Fasting Insulin (FI)
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Fasting Insulin (FI) will be measured by an electrochemiluminescence immunoassay on the Roche E Modular system in uU/mL.
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Hemoglobin A1c (HbA1c)
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
|
The Hemoglobin A1c (HbA1c) determination on the Roche P Modular system will be based on turbidimetric immunoinhibition using packed red cells.
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Leptin
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Leptin will be measured by an ultra-sensitive ELISA assay, an enzymatically amplified "two-step" sandwich-type immunoassay (R&D Systems, Minneapolis, MN) (pg/mL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Total Adiponectin
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Total Adiponectin (Multimeric) will be measured using an ELISA method from ALPCO Diagnostics Inc. (Salem, NH).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Lipoprotein Profile
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Lipoprotein Profile: will be simultaneously performed on the Roche P Modular system.
Total Cholesterol will be measured enzymatically (mg/dL).
Triglycerides will be measured enzymatically with correction for endogenous glycerol (mg/dL).
The concentration of High Density Lipoprotein Cholesterol will be determined using a direct enzymatic colorimetric assay (mg/dL).
Low Density Lipoprotein Cholesterol will be determined by a homogenous direct method (mg/dL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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High Sensitivity C-Reactive Protein
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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The concentration of High Sensitivity C-Reactive Protein (hsCRP) will be determined using an immunoturbidimetric assay on the Roche P Modular system using reagents and calibrators from DiaSorin (Stillwater, MN) (mg/L).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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TNF
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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TNF-receptor II is measured by an ELISA assay from R&D Systems (pg/mL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Albumin-to-creatinine ratio (ACR)
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Albumin-to-creatinine ratio (ACR): Albumin will be measured by a colorimetric assay, an automated dye-binding method using the Roche P Modular system and Roche Diagnostics reagents (Indianapolis, IN) (g/dL).
Creatinine will be measured by an enzymatic method using the Roche P Modular system and Roche Diagnostics reagents (Indianapolis, IN) (mg/dL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Fetuin-A
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Fetuin-A will be measured by an enzyme immunoassay (EIA) (BioVendor - Candler, NC) (ng/mL).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Physical activity
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Total activity according to intensity will be measured via the Pregnancy Physical Activity Questionnaire (PPAQ) and hip worn accelerometer.
(MET-hrs/week).
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Dietary Intake
Time Frame: 6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Total calories, along with the other nutrients, will be measured via three 24-hr dietary recalls.
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6 weeks postpartum, 6 months postpartum, 12 months postpartum
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Chasan-Taber L, Marcus BH, Rosal MC, Tucker KL, Hartman SJ, Pekow P, Braun B, Moore Simas TA, Solomon CG, Manson JE, Markenson G. Estudio Parto: postpartum diabetes prevention program for hispanic women with abnormal glucose tolerance in pregnancy: a randomised controlled trial - study protocol. BMC Pregnancy Childbirth. 2014 Mar 10;14:100. doi: 10.1186/1471-2393-14-100.
- Wilkie G, Leung K, Moore Simas TA, Tucker KL, Chasan-Taber L. The Association Between Acculturation and Diet and Physical Activity Among Pregnant Hispanic Women with Abnormal Glucose Tolerance. J Womens Health (Larchmt). 2022 Dec;31(12):1791-1799. doi: 10.1089/jwh.2022.0017. Epub 2022 Aug 30.
- Moore Simas TA, Leung K, Nuss E, Marieni M, Marcus B, Rosal MC, Chasan-Taber L. Factors Associated with Risk of Perinatal Depressive Symptoms Among Puerto Rican Women with Hyperglycemia. Matern Child Health J. 2022 Aug;26(8):1741-1751. doi: 10.1007/s10995-022-03429-y. Epub 2022 Apr 6.
- Hawkins M, Marcus B, Pekow P, Rosal MC, Tucker KL, Spencer RMC, Chasan-Taber L. The Impact of a Randomized Controlled Trial of a Lifestyle Intervention on Sleep Among Latina Postpartum Women. Ann Behav Med. 2021 Aug 23;55(9):892-903. doi: 10.1093/abm/kaaa118.
- Gubrium A, Leckenby D, Harvey MW, Marcus BH, Rosal MC, Chasan-Taber L. Perspectives of health educators and interviewers in a randomized controlled trial of a postpartum diabetes prevention program for Latinas: a qualitative assessment. BMC Health Serv Res. 2019 Jun 6;19(1):357. doi: 10.1186/s12913-019-4207-x.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
January 1, 2013
Primary Completion (ACTUAL)
June 1, 2018
Study Completion (ACTUAL)
June 1, 2018
Study Registration Dates
First Submitted
August 7, 2012
First Submitted That Met QC Criteria
August 30, 2012
First Posted (ESTIMATE)
September 5, 2012
Study Record Updates
Last Update Posted (ACTUAL)
April 29, 2020
Last Update Submitted That Met QC Criteria
April 27, 2020
Last Verified
April 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NIH 2R01DK064902-06A1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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