{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:27Z","timestamp":1785545067803,"version":"3.56.0"},"reference-count":32,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Medical nutrition therapy (MNT) serves as the foundational intervention in the clinical management of gestational diabetes mellitus (GDM) management. However, inadequate supportive care often hinders patients\u2019 ability to sustain dietary modifications and self-management behaviors, particularly for complex regimens. Flexible online interventions are thus gaining interest as adjuncts to clinical care, with the potential to improve the outcomes of GDM self-management.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study sought to evaluate the benefits of WeChat-delivered medical nutrition therapy (WeMNT), a WeChat-delivered MNT intervention, for patients with GDM.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A parallel-group, single-blind randomized controlled trial (with outcome assessor blinding) was implemented at a university hospital\u2019s obstetric clinic. Eligible participants were those with a 24\u2010 to 28-week singleton pregnancy, a GDM diagnosis confirmed by the 75 g oral glucose tolerance test, no requirement for insulin therapy, and the ability to use a smartphone and WeChat, as well as to communicate in Chinese. Participants were randomized 1:1 to the intervention (n=47, 50%) or control group (n=47, 50%) using a random number table. The WeMNT intervention was designed per the behavior change wheel framework: (1) analyze capability-, opportunity-, and motivation-based barriers related to MNT adherence; (2) formulate targeted intervention functions; and (3) select evidence-based behavior change techniques. Three WeChat mini-programs served as the core delivery platform to implement the multifaceted intervention functions. The primary outcomes measured in this study included fasting blood glucose, 2-hour postprandial glucose (2hPG), hemoglobin A\n 1c<\/jats:sub>\n (HbA\n 1c<\/jats:sub>\n ), and gestational weight gain (GWG). The secondary outcomes assessed included obstetric complications and neonatal parameters. Intention-to-treat analysis using adjusted generalized linear mixed models was conducted to evaluate the effects of the intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n From March 2023 to October 2023, a total of 94 participants were enrolled in this study. Among the participants, 88 (93.62%) individuals (mean age 32.18, SD 5.04 years) successfully completed the study, 44 (46.81%) in the intervention group and 44 (46.81%) in the control group. Approximately 68.18% (30\/44) of the participants in the intervention group demonstrated sustained adherence, as expected, adhered to the diet plan \u226560% of the days. Compared with the control group, the intervention group showed a significantly greater decrease in GWG over time (group\u00d7time interaction: \u03b2=\u22121.96, 95% CI \u22123.58 to \u22120.34;\n P<\/jats:italic>\n =.02), with no significant effects on fasting blood glucose. Conversely, significant decreases in 2hPG (\u03b2=\u22120.12, 95% CI \u22120.19 to \u22120.04;\n P<\/jats:italic>\n <.001) and HbA\n 1c<\/jats:sub>\n (\u03b2=\u22120.49, 95% CI \u22120.74 to \u22120.23;\n P<\/jats:italic>\n <.001) were noted in the intervention group. No unexpected maternal adverse events occurred, and no significant effects on other health outcomes were detected.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n As a WeChat-delivered, behavior change wheel\u2013informed intervention, WeMNT successfully reduced 2hPG, HbA\n 1c<\/jats:sub>\n , and GWG in GDM management. Its integrated self-management model yields robust evidence, validating this patient-centered tool as a viable option for clinical adoption.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/67410","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T19:11:51Z","timestamp":1781205111000},"page":"e67410-e67410","source":"Crossref","is-referenced-by-count":0,"title":["WeChat-Delivered Mobile Medical Nutrition Therapy Intervention in Gestational Diabetes Mellitus: Randomized Controlled Trial"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-9415","authenticated-orcid":false,"given":"XiaoRong","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-3476","authenticated-orcid":false,"given":"MiaoMiao","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2367-2547","authenticated-orcid":false,"given":"Fang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0663-4893","authenticated-orcid":false,"given":"Chang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-9934","authenticated-orcid":false,"given":"LiNing","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S081","article-title":"Diagnosis and classification of diabetes mellitus","volume":"37 Suppl 1","author":"American Diabetes Association","journal-title":"Diabetes Care"},{"key":"R2","unstructured":"Magliano DJ Boyko EJ . International Diabetes Federation Diabetes Atlas 10th Edition Scientific Committee. 10th edition ed. International Diabetes Federation; 2021. ISBN: 978-2-930229-98-0"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.112183","article-title":"Gestational diabetes mellitus - A metabolic and reproductive disorder","volume":"143","author":"Choudhury","journal-title":"Biomed Pharmacother"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-067946","article-title":"Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis","volume":"377","author":"Ye","journal-title":"BMJ"},{"issue":"1 Suppl 1","key":"R5","doi-asserted-by":"publisher","first-page":"S306","DOI":"10.2337\/dc25-S015","article-title":"15. Management of diabetes in pregnancy: standards of care in diabetes-2025","volume":"48","author":"American Diabetes Association Professional Practice Committee","journal-title":"Diabetes Care"},{"issue":"7","key":"R6","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.2337\/dc18-0102","article-title":"Gestational diabetes mellitus and diet: a systematic review and meta-analysis of randomized controlled trials examining the impact of modified dietary interventions on maternal glucose control and neonatal birth weight","volume":"41","author":"Yamamoto","journal-title":"Diabetes Care"},{"issue":"22","key":"R7","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003792","article-title":"Effects of low glycemic index diets on gestational diabetes mellitus: a meta-analysis of randomized controlled clinical trials","volume":"95","author":"Wei","journal-title":"Medicine (Baltimore)"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.04.004","article-title":"Nutrition therapy within and beyond gestational diabetes","volume":"145","author":"Hernandez","journal-title":"Diabetes Res Clin Pract"},{"issue":"8","key":"R9","doi-asserted-by":"publisher","DOI":"10.3390\/nu13082599","article-title":"The carbohydrate threshold in pregnancy and gestational diabetes: how low can we go?","volume":"13","author":"Sweeting","journal-title":"Nutrients"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5266919","article-title":"An update of medical nutrition therapy in gestational diabetes mellitus","volume":"2021","author":"Vasile","journal-title":"J Diabetes Res"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1002\/oby.20831","article-title":"Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial","volume":"22","author":"Vesco","journal-title":"Obesity (Silver Spring)"},{"issue":"8","key":"R12","doi-asserted-by":"publisher","DOI":"10.3390\/nu16081217","article-title":"Gestational diabetes mellitus: what can medical nutrition therapy do?","volume":"16","author":"Wei","journal-title":"Nutrients"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2022.2087298","article-title":"Self-management and self-efficacy of women with gestational diabetes mellitus: a systematic review","volume":"15","author":"Karavasileiadou","journal-title":"Glob Health Action"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-1657-9","article-title":"Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study","volume":"18","author":"Parsons","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1016\/j.wombi.2018.03.001","article-title":"Self-management of gestational diabetes among Chinese migrants: a qualitative study","volume":"32","author":"Wah","journal-title":"Women Birth"},{"issue":"6","key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/14486","article-title":"Barriers to gestational diabetes management and preferred interventions for women with gestational diabetes in Singapore: mixed methods study","volume":"4","author":"Hewage","journal-title":"JMIR Form Res"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","DOI":"10.3390\/nu15030487","article-title":"Supports and barriers to lifestyle interventions in women with gestational diabetes mellitus in Australia: a national online survey","volume":"15","author":"Sabag","journal-title":"Nutrients"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/51691","article-title":"Baseline perceptions of women with gestational diabetes mellitus and health care professionals about digital gestational diabetes mellitus self-management health care technologies: interview study among patients and health care professionals","volume":"10","author":"Safiee","journal-title":"JMIR Hum Factors"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","journal-title":"Implement Sci"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"676","DOI":"10.2337\/dc09-1848","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"International Association of Diabetes and Pregnancy Study Groups Consensus Panel","journal-title":"Diabetes Care"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-02892-1","article-title":"Effectiveness of telemedicine for pregnant women with gestational diabetes mellitus: an updated meta-analysis of 32 randomized controlled trials with trial sequential analysis","volume":"20","author":"Xie","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses","volume":"41","author":"Faul","journal-title":"Behav Res Methods"},{"issue":"10","key":"R23","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7135","article-title":"Characterizing active ingredients of eHealth interventions targeting persons with poorly controlled type 2 diabetes mellitus using the behavior change techniques taxonomy: scoping review","volume":"19","author":"Kebede","journal-title":"J Med Internet Res"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"Michie","journal-title":"Ann Behav Med"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/55844","article-title":"Effects of a mobile health intervention based on behavioral integrated model on cognitive and behavioral changes in gestational weight management: randomized controlled trial","volume":"27","author":"Zhou","journal-title":"J Med Internet Res"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/43979","article-title":"Supporting the management of gestational diabetes mellitus with comprehensive self-tracking: mixed methods study of wearable sensors","volume":"8","author":"Kyt\u00f6","journal-title":"JMIR Diabetes"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000015","article-title":"Digital health interventions for gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials","volume":"1","author":"Leblalta","journal-title":"PLOS Digit Health"},{"issue":"11","key":"R28","doi-asserted-by":"publisher","first-page":"7130","DOI":"10.1002\/nop2.1988","article-title":"Self-reported barriers in self-management of women with gestational diabetes: a systematic review of qualitative studies","volume":"10","author":"Xu","journal-title":"Nurs Open"},{"issue":"12","key":"R29","doi-asserted-by":"publisher","first-page":"2508","DOI":"10.2337\/dc11-0632","article-title":"Contributions of basal and postprandial hyperglycemia over a wide range of A1C levels before and after treatment intensification in type 2 diabetes","volume":"34","author":"Riddle","journal-title":"Diabetes Care"},{"issue":"4","key":"R30","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1080\/14767058.2018.1497595","article-title":"Influence of low-glycemic index diet for gestational diabetes: a meta-analysis of randomized controlled trials","volume":"33","author":"Xu","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"4","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/13013","article-title":"A promising food-coaching intervention program to achieve optimal gestational weight gain in overweight and obese pregnant women: pilot randomized controlled trial of a smartphone app","volume":"3","author":"Li","journal-title":"JMIR Form Res"},{"issue":"3","key":"R32","doi-asserted-by":"publisher","DOI":"10.2196\/26091","article-title":"Effectiveness of a smartphone app to promote healthy weight gain, diet, and physical activity during pregnancy (HealthyMoms): randomized controlled trial","volume":"9","author":"Sandborg","journal-title":"JMIR Mhealth Uhealth"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e67410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:27:58Z","timestamp":1785536878000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e67410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":32,"URL":"https:\/\/doi.org\/10.2196\/67410","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"article-number":"v14i1 Suppl 1e67410"}}