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Despite this elevated risk, few trials on the prevention of T2DM among South Asian women with GDM have been reported. Therefore, this study aimed to assess the feasibility of conducting a diabetes prevention program on women with a history of GDM to inform the development of a contextually relevant definitive trial.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using a randomized controlled trial, women with GDM (<jats:italic>n<\/jats:italic>\u2009=\u2009180) who delivered at the study hospitals (one public and one private teaching hospital, Karachi) with fasting blood glucose levels\u2009&lt;\u2009120\u00a0mg\/dl at 6\u00a0weeks postpartum were randomized to the intervention (<jats:italic>n<\/jats:italic>\u2009=\u200988) or control arms (<jats:italic>n<\/jats:italic>\u2009=\u200992). Women in the intervention group received individualized home-based educational sessions from trained community health workers at 0, 1, 3, 6, and 9\u00a0months. In addition, they received short text messages, prerecorded messages, and printed educational material (calendars and pamphlets) for reinforcement. The intervention was centered on equipping women with knowledge, skills, and confidence to eat a healthy diet rich in fruits, vegetables, and low-fat dairy products and perform regular physical activity based on walking and household chores to reduce weight (up to 5% of their initial body weight). Women in the control arm received standard care. The feasibility outcomes of the study included screening, recruitment, and retention rates and in-depth interviews at 6\u00a0months post-intervention to explore women\u2019s experiences with the intervention. Descriptive analysis and thematic analysis were performed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 324 women screened during the antenatal care visits and after delivery, 255 (78.7%) were contactable 6\u00a0weeks postpartum, and 180 (70.6%) were eligible and randomized to intervention (<jats:italic>n<\/jats:italic>\u2009=\u200988) and control (<jats:italic>n<\/jats:italic>\u2009=\u200992) groups. Loss to follow-up in the intervention and control arms was 22.7% (<jats:italic>n<\/jats:italic>\u2009=\u200920\/88) and 18.5% (<jats:italic>n<\/jats:italic>\u2009=\u200917\/92), respectively. Women expressed satisfaction with home-based counseling and follow-up visits, text message reminders, and printed material in the form of a calendar through our qualitative interviews.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Home-based lifestyle modification intervention augmented with text messages and printed material is feasible. However, to evaluate the intervention\u2019s effectiveness, a larger trial is warranted to assess its long-term impact on diabetes prevention.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ISRCTN, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN11387113\">ISRCTN11387113<\/jats:ext-link>. Registered 5 December 2017\u2014retrospectively registered.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40814-024-01514-3","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T08:02:38Z","timestamp":1718438558000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Conducting a diabetes mellitus prevention trial in women with GDM in Pakistan: a feasibility study"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5364-4366","authenticated-orcid":false,"given":"Romaina","family":"Iqbal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabahat","family":"Naz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahat","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Bhutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleema","family":"Yasmeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqbal","family":"Azam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramjit","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"1514_CR1","unstructured":"Diabetes around the World in 2021: International Diabetes Federation (IDF); 2021. 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Written informed consent was obtained from study participants before participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"92"}}