title: A web-based pedometer programme in women with a recent history of gestational diabetes.
abstract: OBJECTIVE
  Women with remote histories of gestational diabetes mellitus can reduce their diabetes risk through lifestyle changes, but the effectiveness of interventions in women with more recent histories of gestational diabetes has not been reported. Therefore, we conducted a pilot study of a low-intensity web-based pedometer programme targeting glucose intolerance among women with recent gestational diabetes.
  
  
  METHODS
  Women with a gestational diabetes delivery within the past 3 years were randomized to a 13-week intervention consisting of a structured web-based pedometer programme which gave personalized steps-per-week goals, pedometers and education regarding lifestyle modification, or to a letter about diabetes risk reduction and screening after delivery for gestational diabetes (control condition). The main outcome measures were change in fasting plasma glucose and 2-h glucose levels on a 75-g oral glucose tolerance test between baseline and 13-week follow-up. Weight was a secondary outcome and behavioural constructs (self-efficacy, social support, risk perception) were also assessed.
  
  
  RESULTS
  Forty-nine women were enrolled. At 13-week follow-up, women randomized to the intervention did not have significant changes in behavioural constructs, physical activity or anthropometrics compared with women in the control group. Changes in fasting plasma glucose (-0.046 mmol/l vs. 0.038 mmol/l, P = 0.65), 2-h glucose values (-0.48 mmol/l vs. -0.42 mmol/l, P = 0.91) and weight (-0.14 kg vs. -1.5 kg, P = 0.13) were similar between the control and intervention groups, respectively.
  
  
  CONCLUSIONS
  Structured web-based education utilizing pedometers is feasible although uptake may be low. Such programmes may need to be supplemented with additional measures in order to be effective for reduction of diabetes risk.
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, USA. cathkim@umich.edu
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Draska
authors.forename: M L
authors.initials: ML
authors.lastname: Hess
authors.forename: E J
authors.initials: EJ
authors.lastname: Wilson
authors.forename: C R
authors.initials: CR
authors.lastname: Richardson
mesh_terms: D000328:Adult; D001835:Body Weight; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology / Q000534:rehabilitation*; D005951:Glucose Tolerance Test; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008019:Life Style; D008824:Michigan / Q000453:epidemiology; D010865:Pilot Projects; D011247:Pregnancy; D011795:Surveys and Questionnaires; D016138:Walking