MoDiab-Web - Web-based support to women with type 1 diabetes during pregnancy and early motherhood
Every year, about 500 Swedish women with type 1 diabetes give birth. Type 1 diabetes complicates pregnancy as well as childbirth and increases the risk of adverse outcomes such as fetal malformations, pre-eclampsia, macrosomia, instrumental vaginal birth and caesarian sections and neonatal complications such as hypoglycemia and or respiratory distress.
Near-normal blood glucose levels in the pregnant mother are the most important factor in a successful pregnancy ending in a healthy baby with a normal birthweight. The insulin needs increases two to three fold during pregnancy. To parry the successively increased insulin need, intensive blood glucose controls, 24/7, and continuous insulin dose increases combined with a structured diet and activity plan is necessary. The pregnant women often worry about the health of their unborn child. Directly after childbirth the insulin needs decreases, often to less than the pre-gestational levels. The new mother is in a vulnerable position, trying to establish breastfeeding, care for her new baby and finding new daily routines, whilst managing her often unpredictable blood glucose levels.
To investigate if and how the implementation of a web-based support program could improve self-efficacy of diabetes management and general well-being during pregnancy and in the first six months of motherhood.
That a person-centered web-based support, that enables users to document their experiences and share in decision-making related to their care, strengthens self-management capabilities and thus well-being in women with type 1 diabetes during pregnancy, childbirth and early motherhood.
The study is registered at Clinical Trials: clinicaltrials.gov NCT01565824
Phase 1: Design and development of the web-based support and documentation of the intervention. This phase is completed (1-4).
Phase 2: The intervention, a randomized controlled study. Data collection took place between November 2011 and March 2016. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes has been studied (5). The analysis of the effect of the intervention is ongoing.
1. Adolfsson A, Jansson M. Prototype for Internet support of pregnant women and mothers with type 1 diabetes: focus group testing. Psychology research and behavior management. 2012;5:97-103.
2. Adolfsson A, Linden K, Sparud-Lundin C, Larsson P-G, Berg M. A web-based support for pregnant women and new mothers with type 1 diabetes mellitus in Sweden (MODIAB-Web): study protocol for a randomized controlled trial. Trials. 2014;15(1):513.
3. Berg M, Adolfsson A, Ranerup A, Sparud-Lundin C. Person-centered Web support to women with type 1 diabetes in pregnancy and early motherhood--the development process. Diabetes Technol Ther. 2013 Jan;15(1):20-5.
4. Linden K, Berg M, Sparud-Lundin C. Web-based information for pregnant women and new mothers with type 1 diabetes--a description of the development process. BMC Med Inform Decis Mak. 2012;12:134.
5. Linden K, Sparud-Lundin C, Adolfsson A, Berg M. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus. International journal of environmental research and public health. 2016;13(8):836.