Grant: Team Grant: Prevention and Treatment of Type 2 Diabetes - full application

Women who have had gestational diabetes mellitus (GDM), which is a temporary diabetes that develops during pregnancy, are at high risk of getting type 2 diabetes sometime after their pregnancy. Research has shown that increasing physical activity, eating a healthier diet and losing weight, can prevent the progression to long term diabetes. This research study involves developing and evaluating an innovative intervention for the South African health system that will help prevent women with previous GDM from developing type 2 diabetes in the years after pregnancy. The study setting is in the cities of Cape Town and Johannesburg and will specifically target women at risk from poor communities who use the public health system. The proposed intervention will consist of offering the women a special test to see whether they have diabetes 6 weeks after delivery, along with counselling about a healthy lifestyle from a trained counsellor at the clinic and in a community venue. Currently, no such test, information or counselling support exists for these women after they have had their babies. The intervention will be introduced at primary care clinics, where mothers usually go to have their babies vaccinated during their first year of life, in order to make it convenient for them to access the service. This also offers an opportunity to test a post-partum intervention which addresses the mother's and child's health and nutrition together, rather than separately as is current practice. Before and during the implementation of the intervention, research with women, healthcare providers and health service managers will help to ensure that the proposed components of the intervention are suitable and practical in the real life clinic and community setting. If the intervention proves to be effective in preventing diabetes, further research and advocacy activities will explore the opportunities and barriers to extending the intervention across the SA health services more broadly.