MATERIALS AND METHODS
Study Design: A randomised control trial was carried out in the
Illawarra Shoalhaven Local Health District (ISLHD) and greater Sydney
area, NSW, Australia from September 2018 to March 2022. Study
recruitment and data collection were paused from March 2020 to October
2021 due to the coronavirus pandemic restrictions. A Consolidated
Standards of Reporting Trials (CONSORT) flow diagram indicating
recruitment and enrolment during these periods is provided as Figure 1.
Women were randomised 1:1, via a third-party computer generator, to
standard-care which includes advice to perform 30 minutes of physical
activity daily (Control (CTL)) or standard-care with intervention advice
to perform three 10-min bouts of postmeal walking (PMW: 30 minutes
broken up into 10 min walking, within 60 minutes of breakfast, lunch,
and dinner) (Figure 1). To understand the real-world impact and future
translation, the intervention for this pragmatic pilot trial was
delivered alongside standard-care and undertaken in free-living habitual
conditions with minimal contact by researchers. Concurrently, using
continuous glucose monitors (CGM) and inclinometers for physical
activity, we were able to assess the glycaemic impact and adherence to
our physical activity prescriptions in the free-living environment. This
study was approved by the joint University of Wollongong and ISLHD
ethics committee (HREC: 2018/318; ACTRN12618001355268) with written
informed consent provided by all women at the first meeting with
researchers.
Participants: Women with GDM were recruited via social media
callouts (in the greater Sydney area) and group education sessions at
the Illawarra Shoalhaven Local Health District Diabetes Service.
Participants were eligible for this study with a diagnosis of GDM
according to the International Association of Diabetes in Pregnancy
Study Group criteria [4], were aged > 18 years, and
were <30 weeks’ gestation. Exclusion criteria included
<18 years, high-risk pregnancies, women with prescriptions for
metformin or corticosteroids, contraindications to performing physical
activity, or women on pre-existing medications for conditions such as
hypertension, cardiac disease, renal disease, thyroid disease, or
psychosis.