A Window of Opportunity

Diabetes prevention and support as a key piece of postpartum care 

Between five and 10 per cent of pregnancies will result in the development of temporary gestational diabetes, putting individuals at increased risk of developing type 2 diabetes in the future. Yet, most women pre-disposed to this condition are only being screened once for type 2 diabetes anywhere between six weeks to six months after giving birth.   

“If we’ve identified that someone has higher risk for type 2 diabetes, we owe it to those women to help them navigate their diagnosis,” says Dr. Lorraine Lipscombe, Senior Scientist at Women’s College Research Institute (WCRI) and Endocrinologist at Women’s College Hospital (WCH).   

That’s why Dr. Lipscombe, along with her team of researchers, started the Avoiding Diabetes After Pregnancy Trial in Moms (ADAPT-M) program, modelled after WCH’S own Women’s Cardiovascular Health Initiative, which offers telephone-based health coaching.  

Dr. Lipscombe has identified this postpartum period as “a huge window of opportunity to identify and reduce risk for women,” when it comes to developing type 2 diabetes. She adds that women deserve “wraparound care” that accounts for those who face a greater likelihood of developing this condition during and following pregnancy.  

“ADAPT-M provides postpartum women at increased risk of type 2 diabetes with health coaches who are trained diabetes educators,” says Dr. Lipscombe. “The educators provide short, frequent follow-up calls to help women meet their own goals.”   

The ADAPT-M program was created with gender and sex-specific barriers to care that women face in mind, and to provide a holistic approach to health and wellness care that is deserved and needed after pregnancy, Dr. Lipscombe notes. “New mothers have competing priorities; they are often expected to be a good mom and a good partner while also juggling the physical demands of being postpartum,” says Dr. Lipscombe.   

We saw that many places had tried to create classes and counselling opportunities to be given this support, but it wasn’t really working. Women weren’t going, and one-time counselling was shown to be really ineffective. 

This is why the program offers care that is almost entirely virtual – participants receive two health assessments before and after the study, that include questionnaires and blood tests. They also receive a one-on-one counselling session with one of the program’s diabetes education partners on health prevention and health behavior changes. They are then offered a home-based physical activity program, a home-based nutrition program, or a combination of the two.   

“Being part of the program was very positive for me and I was glad to have people checking in on me.” says one of the ADAPT-M participants. “It kept me thinking about my health. When a baby is born, you devote all your resources to the baby and you kind of forget yourself for a while, but it helped me think a little bit about me.” 

Next: A History of Looking Forward »

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