# A Shared Decision Making Intervention for Diabetes Prevention in Women with a History of Gestational Diabetes Mellitus.

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2021 · $589,875

## Abstract

PROJECT SUMMARY/ABSTRACT
Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes
(T2DM). Evidence from the Diabetes Prevention Program indicates that lifestyle change and metformin use in
this population are clinically equivalent, each reducing the incidence of T2DM by approximately 50% among
women with a GDM history. These women face a preference-sensitive decision between the evidence-based
alternatives. Shared decision making (SDM) is an attractive approach in this situation, using a decision aid to
make the decision explicit, describe the available options with equipoise, elicit patient preferences, and help
patients make an informed decision that is right for them. To our knowledge, there are no existing studies
evaluating SDM for diabetes prevention among women with a history of GDM.
Our team has extensive experience with a team-based SDM approach for diabetes prevention, and our prior
work showed that this approach leads to increased uptake of an evidence-based diabetes prevention strategy
(lifestyle change, metformin or both) as well as sustained weight loss at 12-month follow-up in a broader
population with prediabetes. We have also completed a pilot test of SDM among 33 women with a GDM
history, demonstrating feasibility and acceptability. In this proposal, we aim to evaluate SDM for diabetes
prevention among women with a history of GDM and prediabetes within two health systems (UCLA and
Intermountain). Pharmacists will implement the intervention at UCLA, and clinic care managers will implement
the intervention at Intermountain. Our Specific Aims are as follows: To test the effectiveness of an RCT
evaluating SDM for diabetes prevention on 1) weight loss among overweight/obese women with a history of
GDM and hemoglobin A1c between 5.7-6.4%, 2) uptake of lifestyle change and/or metformin use, patient-
reported outcomes (physical activity, eating patterns, patient activation, health-related quality of life), annual
follow-up screening for progression to T2DM, and rates of GDM in a subsequent pregnancy (exploratory
outcome), and 3) to evaluate the incremental cost of program implementation per woman with a history of
GDM and hemoglobin A1c between 5.7-6.4% who successfully initiates lifestyle change and/or metformin. Our
application presents a unique opportunity to implement a rigorous project addressing a critical area of unmet
need in diabetes prevention for women with history of GDM, leveraging our health system infrastructure and
our collaborative, multidisciplinary team with a strong record of accomplishment in diabetes prevention. This
work will provide pragmatic, effective and sustainable approaches to increase evidence-based diabetes
prevention strategies for women with a history of GDM that can be readily adopted in other health systems.

## Key facts

- **NIH application ID:** 10147209
- **Project number:** 1R01DK127733-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** OBIDIUGWU KENRIK DURU
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $589,875
- **Award type:** 1
- **Project period:** 2021-02-15 → 2025-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10147209

## Citation

> US National Institutes of Health, RePORTER application 10147209, A Shared Decision Making Intervention for Diabetes Prevention in Women with a History of Gestational Diabetes Mellitus. (1R01DK127733-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10147209. Licensed CC0.

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