eHealth v léčbě gestačního diabetu (eMOMGDM) (eMOMGDM)
eHealth v léčbě gestačního diabetu – eMOM GDM – studie (2. fáze)
The overall aim of the eMOM GDM-project is to develop and evaluate a novel system to clinical decision making and patient behavior change in treatment of GDM, combining diet, physical activity, sleep, heart rate (e.g. stress), and glucose monitoring within a single system (the eMOM GDM application), and linking the developed application tool for the normal health care system in a new way.
In this second phase of the project, the effect of eMOM GDM application on maternal and neonatal outcomes will be evaluated in a randomized controlled study design. The follow-up study continues until 3 months postpartum.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
200 women with gestational diabetes will be randomized into the intervention and the control group at gestational week (GW) 24-28.
Participants in the intervention group will use the eMOM GDM -application one week/month until delivery.
The participants in the intervention and the control group visit study nurse 3 times in study period (at GW 24-28 and GW 35-37 and 3 months postpartum).
Both groups also receive regular antenatal care in maternity clinics and hospitals.
Maternal measurements at enrollment, and at 35-37 GW (both groups):
- Laboratory tests: fp-gluc, HbA1c, fp-insu, lipids, hs-CRP
- Fingertips glucose values from glucose meter (belong to normal antenatal care)
- Fasting blood samples for future analyses
- Weight, height, blood pressure (from the antenatal registry and study visits)
- Questionnaires: background (only at enrollment), diet (food frequency questionnaire), depression (EPDS), motivation (TSRQ+PCS), quality of life (15D)
- Physical activity and sedentary behavior with the hip-worn triaxial accelerometer (UKK RM 42)
- Physical activity and heart rate with Firstbeat Bodyguard
Measurements at Birth:
- Cord blood sample
- Placental weight
- Offspring birthweight, height, body composition (PEA POD Cosmed®)
Maternal measurements at 3 months postpartum:
- Laboratory tests: fp-gluc, HbA1c, fp-insu, lipids, hs-CRP
- fp-gluc, 2h postprandial value, as measured during oral glucose tolerance test (OGTT)
- Fasting blood samples for future analyses
- Firstbeat Bodyguard 2 measurement (3 days)
- Depression questionnaire (EPDS)
- Diet questionnaire (FFQ)
Protocol only for the intervention group
- eMOM GDM application: use: 1 application week + 3 normal care weeks repeatedly until delivery
The application includes:
-
continuous glucose monitor (CGM)
- fingertips glucose calibration according to CGM protocol (twice per day with Medtronic)
-
diet (digital food tracker)
- 3 days during one application week
- For ensuring the quality of food record a researcher will phone interview the participant based on her recordings. This is done after each recording period.
-
heartrate, stress and physical activity with the wrist-worn activity tracker (Vivosmart 3)
-
weight measured once a week
Data from the sensors
- Data from users' input to the application
- Technology acceptance questionnaire (UTAUT) after every application week
- Usability questionnaire, after four weeks usage of the eMOM GDM application
- Semi-structured interview
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
-
-
-
Helsinki, Finsko, 00029
- Helsinki University Hospital
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- GDM diagnoses at 24-28 gestational weeks
Exclusion Criteria:
- type 1 or type 2 diabetes
- use of medication that influences glucose metabolism (such as continuous therapy with oral corticosteroids or metformin)
- multiple pregnancy
- physical disability
- current substance abuse
- severe psychiatric disorder (that complicates participation to the study)
- significant difficulty in cooperating (e.g. inadequate Finnish language skills)
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Dvojnásobek
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
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Experimentální: Intervention (eMOM GDM application)
Participants in the intervention group will use the eMOM GDM -application one week/month. The participants will also receive regular antenatal care in maternity clinics and hospitals. In addition they will meet a study nurse three times during study period (at GW 24-28, at GW 35-37 and 3 mo postpartum). |
Participants in the intervention group will use the eMOM GDM -application one week/month. eMOM GDM application includes:
The sensors can be worn and the application used during the whole pregnancy (if a mother is interested in) |
|
Žádný zásah: Control
Participants in the control group will meet a study nurse 3 times during study period (at GW 24-28, at GW 35-37 and 3 mo postpartum). They also receive regular antenatal care in maternity clinics and hospitals. |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Change in fasting glucose
Časové okno: from gestational weeks 24-28 to gestational weeks 35-37
|
change in fasting glucose measured by Huslab (laboratory measurement) |
from gestational weeks 24-28 to gestational weeks 35-37
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Fingertips fasting glucose values
Časové okno: from gestational weeks 24-28 up to delivery
|
Measured with Contour Next One |
from gestational weeks 24-28 up to delivery
|
|
Fingertips postbrandial glucose values
Časové okno: from gestational weeks 24-28 up to delivery
|
Measured with Contour Next One |
from gestational weeks 24-28 up to delivery
|
|
Fingertips area under the glucose curve
Časové okno: from gestational weeks 24-28 up to delivery
|
Measured with Contour Next One |
from gestational weeks 24-28 up to delivery
|
|
Gestational weight
Časové okno: weight measured at gestational weeks 24-28 and at 35-37 and collected from antenatal card during whole pregnancy and up to delivery
|
Measured with Seca Mod 8787041649 (scale) and registered from antenatal card |
weight measured at gestational weeks 24-28 and at 35-37 and collected from antenatal card during whole pregnancy and up to delivery
|
|
Postpartum weight
Časové okno: weight measured at 3 months postpartum
|
Measured with Seca Mod 8787041649 (scale) |
weight measured at 3 months postpartum
|
|
Physical activity level
Časové okno: at gestational weeks 24-28, 35-37 and at 3 months postpartum
|
Measured with the accelerometers UKK RM42 and Firstbeat Bodyguard 2 |
at gestational weeks 24-28, 35-37 and at 3 months postpartum
|
|
Total diet
Časové okno: at gestational weeks 24-28), 35-37 and at 3 months postpartum
|
Measured with a questionnaire (food frequencey questionnaire, FFQ) concerning participant's diet during previous month. FFQ contains questions about the frequency (number of times per day, week, or month) and the amount of foods consumed in units of common serving sizes. Nutritional quality of total diet is assessed based on calculated daily consumption of foods and intake of nutrients. Better nutritional quality is related to e.g. higher intake of fruits and vegetables, wholegrain cereals, fiber and unsaturated fat, and lower intake of added sugar and saturated fat. |
at gestational weeks 24-28), 35-37 and at 3 months postpartum
|
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Neonatal body fat%
Časové okno: one measure within 0-3 days after birth of the child
|
Measured with PEA POD Cosmed |
one measure within 0-3 days after birth of the child
|
|
Motivation to manage GDM
Časové okno: at gestational weeks 24-28 and 35-37
|
Measured with a motivation questionnaire (TSRQ and PCS). Minimum value is 1 and maximum 5. The higher score means higher autonomous motivation to manage GDM. |
at gestational weeks 24-28 and 35-37
|
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Percentage of participants on metformin treatment
Časové okno: up to 42 gestational weeks
|
Percentage of participants need for metformin treatment |
up to 42 gestational weeks
|
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Percentage of participants on insulin treatment
Časové okno: up to 42 gestational weeks
|
Percentage of participants need for insulin treatment |
up to 42 gestational weeks
|
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Newborn birthweight and macrosomia
Časové okno: one measure at birth
|
Newborn birth weight and macrosomia (birthweight >4kg) |
one measure at birth
|
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Incidence of neonatal hypoglycemia
Časové okno: within a week from birth
|
Percentage of neonatal hypoglycemia requiring intravenous glucose |
within a week from birth
|
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Incidence of newborn large for gestational age
Časové okno: one measure at birth
|
Percentage of newborn with birthweight percentile > + 2 SD |
one measure at birth
|
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Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)
Časové okno: gestational weeks 24-28, gestational weeks 35-37, 3 months postpartum
|
Change in HOMA-IR measured by Huslab (laboratory measurement), calculated as: fasting insulin (microU/L) x fasting glucose (nmol/L)/22.5. |
gestational weeks 24-28, gestational weeks 35-37, 3 months postpartum
|
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2-h OGTT
Časové okno: 3 months postpartum
|
2-hour blood glucose levels measured with OGTT (75g) |
3 months postpartum
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Stress levels
Časové okno: gestational weeks 24-28, gestational weeks 35-37, 3 months postpartum
|
Calculated based on dedicated HRV-based algorithm by Firstbeat. Defined as percentages. |
gestational weeks 24-28, gestational weeks 35-37, 3 months postpartum
|
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Costs
Časové okno: gestational weeks 24-28, 3 months postpartum
|
Costs of the intervention and treatment in healthcare. Defined as €/participant. |
gestational weeks 24-28, 3 months postpartum
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Publikace a užitečné odkazy
Obecné publikace
- Kyto M, Markussen LT, Marttinen P, Jacucci G, Niinisto S, Virtanen SM, Korhonen TE, Sievanen H, Vaha-Ypya H, Korhonen I, Heinonen S, Koivusalo SB. Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study). BMJ Open. 2022 Nov 7;12(11):e066292. doi: 10.1136/bmjopen-2022-066292.
- Maattanen S, Koivusalo S, Ylinen H, Heinonen S, Kyto M. The Effect of a Mobile App (eMOM) on Self-Discovery and Psychological Factors in Persons With Gestational Diabetes: Mixed Methods Study. JMIR Mhealth Uhealth. 2025 Jun 4;13:e60855. doi: 10.2196/60855.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- HUS/2165/2018-Phase 2
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
All data will be collected in Helsinki University Hospital Datalake from where pseudo-anonymised data can be requested until 2032 via a data sharing contract. Proposals should be directed to tietopalvelu(a)hus.fi.
Časový rámec sdílení IPD
Until 2032
Typ podpůrných informací pro sdílení IPD
- PROTOKOL STUDY
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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