The Malaysian GestatiOnal Diabetes and prevention of DiabtES Study (MY GODDESS)

妊娠糖尿病是一种在怀孕期间发生的疾病，当血糖高于正常水平时。宝宝出生后，血糖恢复正常。马来西亚每年约有50，000名妇女患有妊娠糖尿病，这些数字随着全球肥胖症的流行而增加。大约一半的妊娠期糖尿病患者可能在10年内发展为2型糖尿病或糖尿病前期。换句话说，这些养育孩子的女性，也可能在外面工作，在30多岁和40多岁时患上糖尿病，比普通人早20年。妊娠糖尿病会导致进一步的健康问题，婴儿可能会出生在大的日期，这增加了他/她在以后的生活中患2型糖尿病的机会。马来人、印度人和马来西亚华人都是患糖尿病的高危人群。如果女性改变生活方式，减轻体重，增加体力活动，患2型糖尿病的几率可能会大大降低。这可能是非常困难的现代生活方式和要求。妊娠期糖尿病通常是一种非常令人不安的经历，因为母亲感到内疚，也担心宝宝的健康。已经有一些试验，主要是在北美，测试不同类型的生活方式，但这些试验的结果并不明确。马来西亚没有报告进行试验。我们仍然不知道什么样的支持对女性最有帮助。国王健康伙伴公司拥有最大的糖尿病临床和研究单位之一。我们一直在开发新的方法来支持患有妊娠糖尿病的妇女（由安格斯福布斯教授和海伦墨菲教授领导）。我们对妊娠期糖尿病女性的采访显示，英国女性对自己患糖尿病的风险了解不多，我们认为马来西亚女性可能也是如此。他们也不知道如何最好地降低风险，并担心运动和不同的饮食可能会伤害他们的宝宝。我们还发现，女性在被告知患有妊娠期糖尿病后变得非常沮丧，内疚和负担。 这个项目被称为我的女神，我们的目标是分享英国和马来西亚妇女的想法和经验。在第一组研究中，我们将回顾已经发表的研究，找出哪些有效，哪些无效。我们将专注于使用数字技术的研究，如应用程序，智能手机或计算机上的网站。然后，我们将采访有妊娠糖尿病史的妇女，询问改变生活方式的困难和帮助。然后，我们将使用我们作为研究人员和患者共享的知识来设计一种新的治疗方法，以支持生活方式的改变。我们将考虑一些想法，如小组会议，生活方式教练短信，以及佩戴测量我们步数和心率的设备。我们将开发可以下载到智能手机上的MY GODDESS应用程序。我们相信，如果我们更好地了解如何利用数字技术中的“健康力量”，我们将建立更强大的支持系统，帮助GDM女性过上更健康的生活方式。第二个项目是测试我们的新疗法，我的女神，在一个小的研究中，看看我们是否可以测试我们的新疗法可以在更大的范围内进行，它确实有助于女性改变生活方式。我们将招募约50名患者。我们将研究有多少妇女，我们可以确定，谁将有兴趣参与，谁将留在治疗结束。我们将询问妇女对她们的经验的反馈，什么有效，什么没有，以及任何改进的建议。在项目结束时，如果我们的发现是在正确的方向，我们将提交一份建议，进行一个全面的试验，以测试我的女神是否在马来西亚更大的妇女样本中工作。

Gestational diabetes is a condition that occurs during pregnancy when the blood sugar is higher than it should be. After the baby is born, the blood sugar returns to normal. The number of women in Malaysia that develop gestational diabetes is about 50,000 each year and these numbers are increasing with the worldwide epidemic of obesity. Around half od the women with gestational diabetes are likely to develop either type 2 diabetes or pre diabetes within 10 years. In other words, these women who are child-rearing and who may also be working outside the home, are developing diabetes in their 30s and 40s, almost 20 years before the average person. Gestational diabetes leads to further health problems and the baby can be born big-for-dates which increases his/her chances of developing type 2 diabetes later in life. Malays, Indian and Chinese Malaysians are all at high risk for getting diabetes.The chances of getting type 2 diabetes could be significantly reduced if women made lifestyle changes to lose weight and increase their physical activity. This can be very difficult with modern lifesyles and demands. Also getting gestational diabetes is usually a very upsetting experience because the mother feels guilty and also worrying about the health of her baby. There have been trials, mainly in North America, testing different types of lifestlyes but the findings from these trials are not clear cut. There have been no trials reported in Malaysia. We still do not know what kind of support women would find the most helpful.King's Health Partners has one of the largest clinical and research units for diabetes. We have been developing new approaches to supporting women with gestational diabetes (led by Prof Angus Forbes and Pro Helen Murphy). Our interviews with women with gestational diabetes showed that women in the UK have a poor understanding of their risk of developing diabetes and we think this might be the same for women in Malaysia. They also did not know how best to lower their risk and worried that exercise and different diet might harm their baby. We also found that women became very upset, guilty and burdened after they were told they had gestational diabetes. This project is called MY GODDESS and we aim to share the ideas and experiences of women in the UK and Malaysia. In the first set of studies, we will review the research already published and find out what works and what doesn't. We will focus on studies that uses digital technology such as apps, websites from the smartphone or computer. We will then interview women with a history of gestational diabetes and ask what was difficult about making lifestyle changes and what helped. We will then use use our shared knowledge as researchers and as patients to design a new treatment to support lifestyle change. We will consider ideas such as group sessions, lifestyle coaches text messages, and wearing devices that measure our step counts and heart rate. We will develop the MY GODDESS app which can be downloaded onto a smartphone. We believe that if we understand better how to harness the 'health power' in digital technology, we will produce stronger support systems to help women with GDM lead healthier lifestyles. The second project is to test our new treatment, MY GODDESS, in a small study to see if we could test our new could be conducted at a largerthat it does help women to make lifestyle changes. We will recruit about 50 patients. We will study how many women we could identify, who will be interested in participating and who will stay in the treatment to the end. We will ask women for feedback about their experience, what worked and what did not and any suggestions about improvement.By the end of the project if our findings are in the right direction, we will submit a proposal to conduct a full scale trial to test whether MY GODDESS works in a much larger sample of women across Malaysia.