Reinforcing annual postpartum diabetes screening in women with previous gestational diabetes (REMIND)

PI Title: Dr Moscho Michalopoulou / Associate Professor Nerys Astbury

Lead Member: University of Oxford

Diabetes is a group of diseases linked with high blood sugar levels. The number of people affected by diabetes is increasing.

Gestational diabetes (GDM) only affects women who are pregnant. GDM causes problems during pregnancy and delivery.
But recent research also shows that, although GDM usually resolves after giving birth, it can cause health problems for
women later in life too.
Women who get GDM are at increased risk of developing type 2 diabetes (T2DM) compared to women who do not get GDM.
Up to 50% of women with GDM develop T2DM within 5 years after birth. Because of this, it is recommended that all women
who get GDM have a diabetes screening test annually after birth. This is because catching and treating T2DM early can help
reduce the risk of diabetes-related complications later in life, such as problems with the eyes, heart, kidney, and feet.
However, most women with GDM do not book or attend the recommended annual diabetes test after birth. If we can
identify an effective way to remind women with previous GDM to book annual diabetes screening in primary care, this could
increase the number of women who attend this screening test. This would be a priority for the NHS to identify and treat
T2DM at the soonest possibility.
Here, we aim to test if sending women with previous GDM an informational SMS text message to remind and encourage
them to book an annual diabetes screening test can increase the number of women who attend this test after GDM. We will
collaborate with women who have had GDM to develop the SMS, such as the language, empowering way to communicate
diabetes risk after GDM, and a potential linked video within the SMS.
We will test this SMS-based intervention in a clinical trial. We will recruit 60 GP practices and divide them into two equal-size
groups. Group A will continue care as usual. Group B will send women with previous GDM the SMS on two occasions
(baseline and after 3 weeks as reminder). After 3 months from baseline, we will compare how many women have a recorded
diabetes test result between the groups.
The findings will provide information to help transform primary care for women affected by GDM. If the SMS-based
intervention is effective compared to usual care, this will mean that more women with previous GDM who progress into
T2DM can be diagnosed in a timely manner and offered treatment early, thus improving long-term health outcomes and
lives of women affected by GDM. The intervention could be rapidly rolled-out into routine primary care. This is because there
is precedent of using similar SMS-based interventions to increase screening in different populations and conditions within
the NHS.