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| Name | Class |
|---|---|
| Mount Saint Vincent University | OTHER |
| Dalhousie University | OTHER |
| The Hospital for Sick Children | OTHER |
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Gestational Diabetes Mellitus (GDM) incidence is increasing worldwide, and within Canada, the Atlantic provinces statistically have been found to have highest prevalence of diabetes. Increasing evidence supports the benefit of following a low glycaemic index (GI) diet in GDM and the Canadian Diabetes Guidelines recommends replacing high GI foods for low GI foods. Despite recommendation to adapt a low GI diet in GDM, there are limitations and barriers recognized to GI utility largely focused on knowledge translation. There is sufficient research to support a low GI diet in benefiting outcomes of GDM, therefore the GI in GDM Online trial will investigate the feasibility and effectiveness of a distance low GI education intervention, adapted from Diabetes Canada's GI materials, on producing a difference in average dietary GI between a group with the intervention and standard care.
The incidence of Gestational Diabetes Mellitus (GDM) has been progressively increasing worldwide, with a global prevalence of gestational hyperglycaemia estimated at 16.9%. In Canada, Atlantic provinces have been recorded with the highest prevalence of diabetes at 6%. The Diabetes Canada Practice Guidelines recommends the low glycemic index (GI) diet to type 1 and 2 diabetes mellitus and has recently updated its guidelines to include a recommendation for GDM. This said, barriers to GI knowledge translation have been identified. This study uses a prospective parallel randomized control trial design. Procedures and materials have been adapted from NCT01589757. The Kirkpatrick Model (Reaction, Learning, Behaviour, and Results) informed intervention development and evaluation strategies. The purpose of this study is to evaluate whether a distance low GI education intervention, adapted from Diabetes Canada's GI education materials, will significantly yield a lower average GI (primary outcome) in participants than traditional standard care medical nutrition therapy for Gestational Diabetes Mellitus. We hypothesize that participants who receive the low GI intervention will have a lower dietary GI than those who received usual IWK standard care for GDM.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Care | No Intervention | Participants will attend a 30-45 min workshop. Trainees will review Diabetes Canada Clinical Practice Guidelines Job Aids (Just the Basics, the Handy Portion Guide, and Basic Carbohydrate Counting) and teach data provision skills (how to complete a three day diet record). | |
| Low Glycemic Index | Experimental | Standard care + Glycemic Index. Participants will attend a 30-45 min workshop. Trainees will review Diabetes Canada Clinical Practice Guidelines Job Aids (Just the Basics, the Handy Portion Guide, and Basic Carbohydrate Counting) and teach data provision skills (how to complete a three day diet record). Diabetes Canada and Dietitian's Canada resources on glycemic index will also be reviewed: the Glycemic Index Food Guide, Flip Cards, and Recipes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low Glycemic Index Education | Behavioral | Educational materials layering Glycemic Index education onto Canada's Food Guide and Diabetes Canada recommendations. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Transfer/KM Level 3: Change in average dietary GI | Average dietary GI; diet record at baseline, 4-6 weeks post-intervention, 4-6 weeks postpartum | From baseline to 4-6 weeks postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| Satisfaction/ KM Level 1: Reaction | Mixed form Questionnaire (GIQ): Close ended format with True or False, Multiple Choice, and Likert Scale choices. Open-ended questions for feedback. | From baseline to 4-6 weeks postpartum |
| Knowledge/KM Level 2: Learning |
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Inclusion Criteria:
Exclusion Criteria; women who:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shannan Grant, PhD, PDt | Contact | 902-457-5400 | shannan.grant2@msvu.ca | |
| Julianne Leblanc, BSc | Contact | (902)470-6532 | julianne.leblanc@iwk.nshealth.ca |
| Name | Affiliation | Role |
|---|---|---|
| Shannan Grant, PhD, PDt | IWK Health Centre | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IWK Health Centre | Recruiting | Halifax | Nova Scotia | B3K 6R8 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29650105 | Background | Diabetes Canada Clinical Practice Guidelines Expert Committee; Feig DS, Berger H, Donovan L, Godbout A, Kader T, Keely E, Sanghera R. Diabetes and Pregnancy. Can J Diabetes. 2018 Apr;42 Suppl 1:S255-S282. doi: 10.1016/j.jcjd.2017.10.038. No abstract available. | |
| 27553869 | Background | Draffin CR, Alderdice FA, McCance DR, Maresh M, Harper Md Consultant Physician R, McSorley O, Holmes VA. Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study. Midwifery. 2016 Sep;40:141-7. doi: 10.1016/j.midw.2016.06.019. Epub 2016 Jun 29. |
| Label | URL |
|---|---|
| Statistics Canada: Diabetes (2017) | View source |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | May 5, 2025 | |
| Reset | May 27, 2025 | |
| Release | Jul 3, 2025 | |
| Reset | Jul 22, 2025 | |
| Release | Aug 5, 2025 | |
| Reset | Aug 20, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| May 5, 2025 | May 27, 2025 | |||
| Jul 3, 2025 |
| ID | Term |
|---|---|
| D016640 | Diabetes, Gestational |
| D001519 | Behavior |
| ID | Term |
|---|---|
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003920 | Diabetes Mellitus |
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Prospective Randomized Control Trial
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Average Quiz Score: Close-ended format, Scored by correct answers. |
| From baseline to 4-6 weeks postpartum |
| Acceptability and Applicability of Education/KM Level 3: Transfer (Behaviour Change) | Mixed form Questionnaire (GIQ): Close ended format using Likert Scale and True or False choices. Open-ended questions for feedback. | From 4-6 weeks post-intervention to 4-6 weeks post-partum |
| Results/KM Level 4: Glycemic Control (rate of Self-monitored blood glucose levels within range) | Medical Record (standard care 2-4 time-points per day) | From Baseline to 4-6 weeks post-partum |
| Maternal Demographics (eg. age, ethnicity, language spoken, education level and work status) | Mixed-form Questionnaire (GIQ) and Medical Chart | Baseline |
| Maternal Height | Medical Record, measured in cm. | Baseline |
| Maternal Pre-Pregnancy body weight | Medical Record, measured in kg. | Baseline |
| Maternal Weight, during pregnancy | Medical Record, measured in kg. | From Baseline to 4-6 weeks post-partum. |
| Background | Layes, A. The Burden of Diabetes in Atlantic Canada. Public Health Agency of Canada, Atlantic Regional Office; 2011. |
| 22254100 | Background | Grant SM, Wolever TMS. Perceived barriers to application of glycaemic index: valid concerns or lost in translation? Nutrients. 2011 Mar;3(3):330-340. doi: 10.3390/nu3030330. Epub 2011 Feb 28. |
| 29958308 | Background | Johnston S, Coyer FM, Nash R. Kirkpatrick's Evaluation of Simulation and Debriefing in Health Care Education: A Systematic Review. J Nurs Educ. 2018 Jul 1;57(7):393-398. doi: 10.3928/01484834-20180618-03. |
| Jul 22, 2025 |
| Aug 5, 2025 | Aug 20, 2025 |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |