This trial aims to evaluate the effectiveness of a Behavioral Modification Working (BMW) Toolkit in improving glycemic control and blood pressure among pregnant women diagnosed with both GDM and PIH.

Gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) are major contributors to maternal and neonatal morbidity, particularly in low- and middle-income countries. Evidence suggests that lifestyle and self-care interventions focusing on diet, physical activity, and sleep may improve maternal outcomes; however, rigorously designed randomized controlled trials evaluating structured behavioral toolkits in Pakistan are scarce.

Inclusion Criteria:

• Pregnant women aged 15-49 years.
• Gestational age between 16 and 20 weeks at enrolment.
• Diagnosed with both gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH).
• At least one prior antenatal visit at the study site.

Exclusion Criteria:

• Pre-existing diabetes mellitus or chronic hypertension prior to pregnancy.
• Pre-existing renal disease, thyroid disease, or major hematological disorders.
• Multiple pregnancy (e.g., twins, triplets).
• Severe psychiatric illness.

De-identified individual participant data (IPD) underlying the results reported in the primary and secondary outcome analyses will be made available to researchers upon reasonable request. Shared data will include demographic, clinical (fasting blood glucose, systolic/diastolic blood pressure), maternal outcomes (e.g., preeclampsia, mode of delivery), neonatal outcomes (e.g., birth weight, gestational age), and knowledge/self-care practice scores. The study protocol, statistical analysis plan, and informed consent form will also be shared.

Data will become available starting 6 months after publication of the primary trial results and will remain available for 5 years.

Access will be granted to researchers who submit a methodologically sound proposal with a clear research question, approved by the principal investigator and the Punjab University Institutional Ethics Review Board. A signed data access agreement ensuring confidentiality and appropriate use is required.

Due to the nature of the behavioral intervention, participants and care providers cannot be blinded. Outcome assessors/data analysts may be blinded where feasible.