Weight LossPhase 2GooDMomS2NCT06948825
Effectiveness Study of a Lifestyle Intervention Versus Metformin in Mothers With Recent Gestational Diabetes
A Phase 2 study testing Metformin Hcl 850Mg Tab, Lifestyle Intervention and Enhanced Lifestyle Intervention in people with Weight Loss and Gestational Diabetes Mellitus in Pregnancy, run by George Washington University at 1 site in United States.
Trial summary
The goal of this clinical trial is to evaluate the effectiveness of a 6-month lifestyle intervention compared to Metformin in postpartum women who have delivered a singleton, live born infant within the last 12 weeks to 1 year and had a pregnancy complicated by gestational diabetes. Read more about this study
- Who is it for?
- Ages 18 to 45 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Weight Loss, Gestational Diabetes Mellitus in Pregnancy, Postpartum Care
- What is being tested?
- Metformin Hcl 850Mg Tab, Lifestyle Intervention and Enhanced Lifestyle Intervention
- Type of treatment
- Pill or oral medicine, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 41 participants
- Where
- 1 siteUnited States
- Study dates
- 27 Oct 2025to May 2027
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Mothers between 8 weeks and 12 months postpartum from a pregnancy complicated by GDM will be recruited. The research team will begin recruiting women who are at least 8 weeks postpartum to provide time to describe the study and answer any questions. Mothers who want to participate will be enrolled in the study between 12 weeks and 12 months postpartum.
- BMI of 25 kg/m2 to 45 kg/m2
- Singleton delivery
- Participants must also have a working cell phone, be willing to accept email or text messages attend Zoom calls, and be willing to be potentially randomized to drug therapy with Metformin.
Who cannot join
- Pregnant or planned pregnancy within the next 6 months.
- Participation in any other weight loss program or taking weight loss medication.
- Normal or underweight BMI (BMI < 24.9 kg/m2)
- Multi-fetal (twins or triplets) gestation
- Women with type 1 or type 2 diabetes, malignancy, other serious co-morbidities (advanced kidney disease, NYHA class 3-4 CHF, advanced COPD), schizophrenia or other major psychiatric disease, and substance abuse or AIDS.
- Women whose infants have significant medical conditions, such as congenital heart disease, renal impairment, or hepatic impairment.
Trial locations and contacts
1 site in 1 country.
United States1 site
Milken Institute School of Public Health - The George Washington University
Washington D.C., District of Columbia, 20052
About this study
The goal of this clinical trial is to evaluate the effectiveness of a 6-month lifestyle intervention compared to Metformin in postpartum women who have delivered a singleton, live born infant within the last 12 weeks to 1 year and had a pregnancy complicated by gestational diabetes. The main question this study aims to answer is:
Is a Lifestyle Intervention or Metformin more effective for weight loss in postpartum women with recent gestational diabetes?
Read more
Researchers will compare a 6-month Lifestyle Intervention and Metformin to see if either intervention is more effective in achieving weight loss and improving health outcomes.
Participants will:
- Attend an in-person baseline visit to receive a Bluetooth-enabled scale and Fitbit, have blood drawn for testing, and have their height, weight, and blood pressure measured. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
- Track diet, physical activity, and weight using the Fitbit and Looseit! apps.
- Attend weekly online group sessions for the first 4 weeks, then biweekly sessions.
- If not meeting weight loss goals, be randomized to either Enhanced Lifestyle Intervention or Metformin arms of the study.
- If randomized to Metformin, participants will attend one in-person meeting with the study provider, get blood drawn for testing, and undergo a urine pregnancy test before starting the medication.
- Continue with biweekly group sessions or have regular check-in calls.
- If randomized to the Enhanced Lifestyle Intervention, participants will get a free Instacart membership, a 1:1 session with the study health counselor focused on meal planning and free grocery delivery once a week for the remainder of the study.
- Participants will meet every other week via Zoom with the health counselor and other participants in the enhanced lifestyle arm.
- At the end of the 6 months, all participants will come for an in-person visit to get blood drawn for testing. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
Read the detailed description
Once enrollment is complete (consent signed), participants will complete the baseline online medical history form and 9 questionnaires available online.
Baseline: Participants will come for an in-person visit to the GW School of Public Health and receive a Bluetooth-enabled digital scale and a Fitbit activity tracker. Research staff will help participants set up a study Fitbit and Looseit! account. Participants will undergo serum blood collection (10 ml) for HgbA1c and lipids. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length. Participants will be asked to use this Fitbit and Looseit! account for the duration of the study to track their diet, activity, and weight. Study staff will access this data, review participant progress, and provide feedback as needed.
Start: All participants will begin with the DPP-based Lifestyle Intervention (LI). The program includes weekly online 45-minute Zoom group sessions for 4 weeks. After week 4, Zoom group sessions will be biweekly. The goal is a 2% weight loss at 4 weeks and a 3% weight loss at 6 weeks. These sessions will be led by a trained health counselor who is part of the research team. The health counselor will review the Fitbit Tracker information and provide tips for improving dietary intake and physical activity via email or text messaging based on the participant's preference.
At the end of week 4 and week 6, participants will submit their weight through Bluetooth-enabled scales.
If they have reached their weight loss goal, they will continue with the lifestyle intervention (LI) with online Zoom group sessions held every other week for the remainder of the intervention (for a total of a 6-month intervention).
After 4 or 6 weeks, participants who have not yet reached their weight loss goal (non-responders) will be randomly assigned to one of two intervention groups:
- DPP-based Enhanced Lifestyle intervention (eLI) OR
- Metformin (850 mg daily x 7 days, then 850 mg twice daily) orally
Enhanced Lifestyle Intervention (eLI): Participants will continue with the same components as the Lifestyle Intervention (LI), with the addition of guidance on healthy meal planning and online grocery shopping, including one free delivery per week. If randomized to this group, participants will continue to have group sessions every other week with others in the eLI arm of the study for the duration of the study (5 or 4.5 months, depending on when they were randomized to the Metformin arm) for a total of a 6-month intervention. Group sessions will last 45-60 minutes each. These sessions will be led by a trained health counselor in the research team. The health counselor will review the Fitbit Tracker and looseit! information and provide tips for improving dietary intake and physical activity via email or text messaging based on the participant's preference.
Metformin Arm: Participants in this arm will have an individual in-person session with the health counselor and study provider where they receive information about 1) the risks and benefits of Metformin for weight loss, 2) potential risks of infant hypoglycemia and the signs/symptoms of infant hypoglycemia, 3) risk factors for development of infant hypoglycemia and the potential long-term effects and consequences of infant hypoglycemia and, 4) guidance on how to take Metformin. After the in-person session, participants will visit the LabCorp facility on the GW Foggy Bottom campus to provide 5 mL of serum for creatinine and liver function testing, as well as undergo a urine pregnancy test. Participants with abnormal liver function tests (ALT outside 4-36 U/L or AST outside 8-33 U/L), eGFR < 60 ml/min, or a positive pregnancy test will be ineligible for Metformin. Once lab results are reviewed, participants will be placed on Metformin by mouth (850 mg daily x 7 days, then 850 mg twice daily). Tablets will be distributed by the Investigational Drug Pharmacy at the George Washington School of Medicine and Health Sciences. This is the current dosage prescribed for weight loss in the clinical setting.
Participants on Metformin will have a 15-minute follow-up call one week after starting the medication to answer additional questions, assess for any medication side effects, and assess for adherence, and then 15-minute follow-up calls by the research team every 2 weeks. Participants will be educated that it is safe to continue to breastfeed while on Metformin, as recommended by the American College of Obstetricians and Gynecologists published recommendations on postpartum care following a pregnancy with GDM. There are no group sessions for this group. Participants will be encouraged to continue practicing healthy lifestyle behaviors learned during the first 4 weeks of the intervention.
End of study: At the end of the study (6 months), participants will complete one questionnaire with updates about their health since their baseline questionnaire and will also complete 9 online questionnaires (same as baseline). Participants will come for an in-person visit where they will be asked to bring their pill container, if they were randomized to the Metformin arm, and provide a 10 ml serum sample for HbA1c, and lipids via LabCorp. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
- Being tested
- Metformin Hcl 850Mg Tab, Lifestyle Intervention, Enhanced Lifestyle Intervention
- Keywords
- diabetes prevention, gestational diabetes, lifestyle intervention
- Medical subject headings
- Weight Loss, Diabetes, Gestational
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Metformin Hcl 850Mg TabDrug
Participants randomized to Metformin will have a prescription of Metformin 850mg orally twice a day. The participant will get blood drawn for testing, undergo a urine pregnancy test, and meet with the study provider to discuss the medication.
Lifestyle InterventionBehavioural
Participants in the Lifestyle Intervention will meet once a week via zoom with the study health counselor to go over lesson plans. After 4 weeks, participants will meet via zoom every other week.
Enhanced Lifestyle InterventionBehavioural
Participants in the Enhanced Lifestyle Intervention will meet every other week, and will get a free instacart membership to have access to free grocery delivery. Additionally, participants in this intervention will have a 1:1 virtual meeting focused on meal planning with the study health counselor.
| Study group | Role | What they receive |
|---|---|---|
| Enhanced Lifestyle (eLI) | Active comparator | Participants will continue with the same components as the Lifestyle Intervention (LI), with the addition of guidance on healthy meal planning and online grocery shopping, including one free delivery per week via instacart. If randomized to this group, participants will continue to have group sessions every other week with others in the eLI arm of the study for the duration of the study (5 or 4.5 months depending on when they were randomized to the Metformin arm) for a total of a 6-month intervention. Group sessions will last 45-60 minutes each. These sessions will be led by a trained health counselor. Receives: Behavioral: Enhanced Lifestyle Intervention |
| Metformin arm (MI) | Active comparator | Participants in this arm will have an individual in-person session with the health counselor and study provider where they receive information about 1) the risks and benefits of Metformin for weight loss, 2) potential risks of infant hypoglycemia and the signs/symptoms of infant hypoglycemia, 3) risk factors for development of infant hypoglycemia and the potential long-term effects and consequences of infant hypoglycemia and, 4) guidance on how to take Metformin.
Participants will be placed on Metformin by mouth (850 mg daily x 7 days, then 850 mg twice daily) and will have a 15-minute follow-up call one week after starting the medication to answer additional questions, assess for any medication side effects, and assess for adherence, and then 15-minute follow-up calls by the research team every 2 weeks. Participants will be encouraged to continue practicing healthy lifestyle behaviors learned during the first 4 weeks of the intervention. Receives: Drug: Metformin Hcl 850Mg Tab |
| Lifestyle Intervention (LI) | Active comparator | All participants will begin with the DPP-based Lifestyle Intervention (LI). This arm includes weekly online 45-minute Zoom group sessions for 4 weeks. After week 4, Zoom group sessions will be biweekly. The goal is a 2% weight loss at 4 weeks and a 3% weight loss at 6 weeks. If participants reach their weight loss goal, they will continue in this arm of the study. These sessions will be led by a trained health counselor. Receives: Behavioral: Lifestyle Intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean weight change at 6 months
Weight in kg.
Measured: 6 months
Secondary outcomes (11)
Change in physical activity
Measured using the Paffenberger Physical Activity Questionnaire, scores are calculated as total weekly energy expenditure in kilocalories per week; higher scores indicate better physical activity levels.
Measured: 6 months
Change in blood pressure
Change in blood pressure, measured in mmHg. A better blood pressure reading is considered below 120/80 mmHg.
Measured: 6 months
Change in A1c
Change in A1c lab value, measured in percentage (%), where a better A1c value is below 5.7%.
Measured: 6 months
Change in lipids
Change in lipids, measured in mg/dL, where a better outcome is total cholesterol below 200mg/dL, HDL above 60 mg/dL, LDL below 100 mg/dL, and triglycerides below 150 mg/dL.
Measured: 6 months
Change in quality of life
Measured using the Short-Form Survey 12, where scores range from 0 to 100. Scores higher than 50 indicate better-than-average health.
Measured: 6 months
Change in depression score
Measured using the Edinburgh Postnatal Depression Scale, with scores ranging from 0 to 30, and lower scores indicating better outcomes. A score of 12 or higher indicates the need to connect with a primary care physician or mental health clinician in the GW School of Medicine or the local community. With the participant's permission, the research staff will facilitate this connection.
Measured: 6 months
Change in diet quality
The research team will review participant diet data via the Ascend platform.
Measured: 6 months
Breastfeeding
A question will be asked at the start and end of the study to determine breastfeeding status.
Measured: 6 months
Adherence to Metformin treatment
Participants will complete a Metformin adherence questionnaire every 2 weeks.
Measured: 4.5 to 5 months
Infant weight
Measured in grams.
Measured: 6 months
Infant length
Measured in centimeters.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Apr 2025
- Study start27 Oct 2025
- Primary completionMay 2027 (estimated)
- Study completionMay 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (24)Papers the sponsor has linked to this study.
- Other trials for Weight LossStudies of the same condition, open and under way.
- More trials run by George Washington UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Sequential
- Model description
- Adaptive trial design. All participants receive the basic lifestyle intervention. If they do not reach their weight loss threshold, they are then randomized to an enhanced lifestyle intervention or Metformin.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 41 participants (actual)
Sponsor and investigators
- Lead sponsor
- George Washington University
- Sponsor type
- University, hospital or other
- Collaborators
- University of North Carolina, Diabetes Sisters, American Diabetes Association
- Responsible party
- Sponsor
- Investigators
- Wanda Nicholson, MD, Principal investigator, The George Washington University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06948825
- Sponsor's protocol ID
- 48359-1-ECNS91615N
- Acronym
- GooDMomS2
- Status last verified
- Nov 2026
- First submitted
- 26 Mar 2025
- Last updated
- 6 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The research team will share unidentified results of outcomes, including clinical and behavioral outcomes.
Publications
Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007 Jul;30 Suppl 2:S141-6. doi: 10.2337/dc07-s206. No abstract available.
PubMed 17596462DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014 Jun 19;11:E104. doi: 10.5888/pcd11.130415.
PubMed 24945238HAPO Study Cooperative Research Group; Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008 May 8;358(19):1991-2002. doi: 10.1056/NEJMoa0707943.
PubMed 18463375Heida KY, Franx A, van Rijn BB, Eijkemans MJ, Boer JM, Verschuren MW, Oudijk MA, Bots ML, van der Schouw YT. Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus. Hypertension. 2015 Dec;66(6):1116-22. doi: 10.1161/HYPERTENSIONAHA.115.06005. Epub 2015 Oct 12.
PubMed 26459420Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012 Jul;35(7):1492-8. doi: 10.2337/dc11-2267. Epub 2012 May 22.
PubMed 22619080Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009 May 23;373(9677):1773-9. doi: 10.1016/S0140-6736(09)60731-5.
PubMed 19465232Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner J, Venditti B, Wylie-Rosett J. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006 Sep;29(9):2102-7. doi: 10.2337/dc06-0560.
PubMed 16936160Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512.
PubMed 11832527Elmer PJ, Grimm R Jr, Laing B, Grandits G, Svendsen K, Van Heel N, Betz E, Raines J, Link M, Stamler J, et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Prev Med. 1995 Jul;24(4):378-88. doi: 10.1006/pmed.1995.1062.
PubMed 7479629Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343-50. doi: 10.1056/NEJM200105033441801.
PubMed 11333990Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH Jr, Kostis JB, Kumanyika S, Lacy CR, Johnson KC, Folmar S, Cutler JA. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998 Mar 18;279(11):839-46. doi: 10.1001/jama.279.11.839.
PubMed 9515998Cassina M, Dona M, Di Gianantonio E, Litta P, Clementi M. First-trimester exposure to metformin and risk of birth defects: a systematic review and meta-analysis. Hum Reprod Update. 2014 Sep-Oct;20(5):656-69. doi: 10.1093/humupd/dmu022. Epub 2014 May 25.
PubMed 24861556Ali MK, Echouffo-Tcheugui J, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program? Health Aff (Millwood). 2012 Jan;31(1):67-75. doi: 10.1377/hlthaff.2011.1009.
PubMed 22232096Phelan S, Hagobian T, Brannen A, Hatley KE, Schaffner A, Munoz-Christian K, Tate DF. Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial. JAMA. 2017 Jun 20;317(23):2381-2391. doi: 10.1001/jama.2017.7119.
PubMed 28632867Castorino K, Jovanovic L. Pregnancy and diabetes management: advances and controversies. Clin Chem. 2011 Feb;57(2):221-30. doi: 10.1373/clinchem.2010.155382. Epub 2010 Dec 9.
PubMed 21148303
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness Study of a Lifestyle Intervention Versus Metformin in Mothers With Recent Gestational Diabetes
- ClinicalTrials.gov ID
- NCT06948825
- Acronym / sponsor ID
- GooDMomS2 / 48359-1-ECNS91615N
- Keywords
- diabetes prevention, gestational diabetes, lifestyle intervention
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 41 participants (actual)
- Lead sponsor
- George Washington UniversityUniversity, hospital or other
- Collaborators
- University of North Carolina, Diabetes Sisters, American Diabetes Association
- Study start
- 27 Oct 2025 (actual)
- Primary completion
- May 2027 (estimated)
- Study completion
- May 2027 (estimated)
- First posted
- 29 Apr 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to evaluate the effectiveness of a 6-month lifestyle intervention compared to Metformin in postpartum women who have delivered a singleton, live born infant within the last 12 weeks to 1 year and had a pregnancy complicated by gestational diabetes. The main question this study aims to answer is:
Is a Lifestyle Intervention or Metformin more effective for weight loss in postpartum women with recent gestational diabetes?
Researchers will compare a 6-month Lifestyle Intervention and Metformin to see if either intervention is more effective in achieving weight loss and improving health outcomes.
Participants will:
- Attend an in-person baseline visit to receive a Bluetooth-enabled scale and Fitbit, have blood drawn for testing, and have their height, weight, and blood pressure measured. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
- Track diet, physical activity, and weight using the Fitbit and Looseit! apps.
- Attend weekly online group sessions for the first 4 weeks, then biweekly sessions.
- If not meeting weight loss goals, be randomized to either Enhanced Lifestyle Intervention or Metformin arms of the study.
- If randomized to Metformin, participants will attend one in-person meeting with the study provider, get blood drawn for testing, and undergo a urine pregnancy test before starting the medication.
- Continue with biweekly group sessions or have regular check-in calls.
- If randomized to the Enhanced Lifestyle Intervention, participants will get a free Instacart membership, a 1:1 session with the study health counselor focused on meal planning and free grocery delivery once a week for the remainder of the study.
- Participants will meet every other week via Zoom with the health counselor and other participants in the enhanced lifestyle arm.
- At the end of the 6 months, all participants will come for an in-person visit to get blood drawn for testing. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
Detailed description
Once enrollment is complete (consent signed), participants will complete the baseline online medical history form and 9 questionnaires available online.
Baseline: Participants will come for an in-person visit to the GW School of Public Health and receive a Bluetooth-enabled digital scale and a Fitbit activity tracker. Research staff will help participants set up a study Fitbit and Looseit! account. Participants will undergo serum blood collection (10 ml) for HgbA1c and lipids. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length. Participants will be asked to use this Fitbit and Looseit! account for the duration of the study to track their diet, activity, and weight. Study staff will access this data, review participant progress, and provide feedback as needed.
Start: All participants will begin with the DPP-based Lifestyle Intervention (LI). The program includes weekly online 45-minute Zoom group sessions for 4 weeks. After week 4, Zoom group sessions will be biweekly. The goal is a 2% weight loss at 4 weeks and a 3% weight loss at 6 weeks. These sessions will be led by a trained health counselor who is part of the research team. The health counselor will review the Fitbit Tracker information and provide tips for improving dietary intake and physical activity via email or text messaging based on the participant's preference.
At the end of week 4 and week 6, participants will submit their weight through Bluetooth-enabled scales.
If they have reached their weight loss goal, they will continue with the lifestyle intervention (LI) with online Zoom group sessions held every other week for the remainder of the intervention (for a total of a 6-month intervention).
After 4 or 6 weeks, participants who have not yet reached their weight loss goal (non-responders) will be randomly assigned to one of two intervention groups:
- DPP-based Enhanced Lifestyle intervention (eLI) OR
- Metformin (850 mg daily x 7 days, then 850 mg twice daily) orally
Enhanced Lifestyle Intervention (eLI): Participants will continue with the same components as the Lifestyle Intervention (LI), with the addition of guidance on healthy meal planning and online grocery shopping, including one free delivery per week. If randomized to this group, participants will continue to have group sessions every other week with others in the eLI arm of the study for the duration of the study (5 or 4.5 months, depending on when they were randomized to the Metformin arm) for a total of a 6-month intervention. Group sessions will last 45-60 minutes each. These sessions will be led by a trained health counselor in the research team. The health counselor will review the Fitbit Tracker and looseit! information and provide tips for improving dietary intake and physical activity via email or text messaging based on the participant's preference.
Metformin Arm: Participants in this arm will have an individual in-person session with the health counselor and study provider where they receive information about 1) the risks and benefits of Metformin for weight loss, 2) potential risks of infant hypoglycemia and the signs/symptoms of infant hypoglycemia, 3) risk factors for development of infant hypoglycemia and the potential long-term effects and consequences of infant hypoglycemia and, 4) guidance on how to take Metformin. After the in-person session, participants will visit the LabCorp facility on the GW Foggy Bottom campus to provide 5 mL of serum for creatinine and liver function testing, as well as undergo a urine pregnancy test. Participants with abnormal liver function tests (ALT outside 4-36 U/L or AST outside 8-33 U/L), eGFR < 60 ml/min, or a positive pregnancy test will be ineligible for Metformin. Once lab results are reviewed, participants will be placed on Metformin by mouth (850 mg daily x 7 days, then 850 mg twice daily). Tablets will be distributed by the Investigational Drug Pharmacy at the George Washington School of Medicine and Health Sciences. This is the current dosage prescribed for weight loss in the clinical setting.
Participants on Metformin will have a 15-minute follow-up call one week after starting the medication to answer additional questions, assess for any medication side effects, and assess for adherence, and then 15-minute follow-up calls by the research team every 2 weeks. Participants will be educated that it is safe to continue to breastfeed while on Metformin, as recommended by the American College of Obstetricians and Gynecologists published recommendations on postpartum care following a pregnancy with GDM. There are no group sessions for this group. Participants will be encouraged to continue practicing healthy lifestyle behaviors learned during the first 4 weeks of the intervention.
End of study: At the end of the study (6 months), participants will complete one questionnaire with updates about their health since their baseline questionnaire and will also complete 9 online questionnaires (same as baseline). Participants will come for an in-person visit where they will be asked to bring their pill container, if they were randomized to the Metformin arm, and provide a 10 ml serum sample for HbA1c, and lipids via LabCorp. Participants will also be asked to bring in their infant, and the study team will measure the infant's weight and length.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Adaptive trial design. All participants receive the basic lifestyle intervention. If they do not reach their weight loss threshold, they are then randomized to an enhanced lifestyle intervention or Metformin.
| Arm | Type | Receives |
|---|---|---|
| Enhanced Lifestyle (eLI) | Active comparator | Behavioral: Enhanced Lifestyle InterventionParticipants will continue with the same components as the Lifestyle Intervention (LI), with the addition of guidance on healthy meal planning and online grocery shopping, including one free delivery per week via instacart. If randomized to this group, participants will continue to have group sessions every other week with others in the eLI arm of the study for the duration of the study (5 or 4.5 months depending on when they were randomized to the Metformin arm) for a total of a 6-month intervention. Group sessions will last 45-60 minutes each. These sessions will be led by a trained health counselor. |
| Metformin arm (MI) | Active comparator | Drug: Metformin Hcl 850Mg TabParticipants in this arm will have an individual in-person session with the health counselor and study provider where they receive information about 1) the risks and benefits of Metformin for weight loss, 2) potential risks of infant hypoglycemia and the signs/symptoms of infant hypoglycemia, 3) risk factors for development of infant hypoglycemia and the potential long-term effects and consequences of infant hypoglycemia and, 4) guidance on how to take Metformin. Participants will be placed on Metformin by mouth (850 mg daily x 7 days, then 850 mg twice daily) and will have a 15-minute follow-up call one week after starting the medication to answer additional questions, assess for any medication side effects, and assess for adherence, and then 15-minute follow-up calls by the research team every 2 weeks. Participants will be encouraged to continue practicing healthy lifestyle behaviors learned during the first 4 weeks of the intervention. |
| Lifestyle Intervention (LI) | Active comparator | Behavioral: Lifestyle InterventionAll participants will begin with the DPP-based Lifestyle Intervention (LI). This arm includes weekly online 45-minute Zoom group sessions for 4 weeks. After week 4, Zoom group sessions will be biweekly. The goal is a 2% weight loss at 4 weeks and a 3% weight loss at 6 weeks. If participants reach their weight loss goal, they will continue in this arm of the study. These sessions will be led by a trained health counselor. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Mothers between 8 weeks and 12 months postpartum from a pregnancy complicated by GDM will be recruited. The research team will begin recruiting women who are at least 8 weeks postpartum to provide time to describe the study and answer any questions. Mothers who want to participate will be enrolled in the study between 12 weeks and 12 months postpartum.
- BMI of 25 kg/m2 to 45 kg/m2
- Singleton delivery
- Participants must also have a working cell phone, be willing to accept email or text messages attend Zoom calls, and be willing to be potentially randomized to drug therapy with Metformin.
Key exclusion criteria (6 listed)
- Pregnant or planned pregnancy within the next 6 months.
- Participation in any other weight loss program or taking weight loss medication.
- Normal or underweight BMI (BMI < 24.9 kg/m2)
- Multi-fetal (twins or triplets) gestation
- Women with type 1 or type 2 diabetes, malignancy, other serious co-morbidities (advanced kidney disease, NYHA class 3-4 CHF, advanced COPD), schizophrenia or other major psychiatric disease, and substance abuse or AIDS.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Metformin Hcl 850Mg TabParticipants randomized to Metformin will have a prescription of Metformin 850mg orally twice a day. The participant will get blood drawn for testing, undergo a urine pregnancy test, and meet with the study provider to discuss the medication. | Drug | Metformin arm (MI) |
| Lifestyle InterventionParticipants in the Lifestyle Intervention will meet once a week via zoom with the study health counselor to go over lesson plans. After 4 weeks, participants will meet via zoom every other week. | Behavioural | Lifestyle Intervention (LI) |
| Enhanced Lifestyle InterventionParticipants in the Enhanced Lifestyle Intervention will meet every other week, and will get a free instacart membership to have access to free grocery delivery. Additionally, participants in this intervention will have a 1:1 virtual meeting focused on meal planning with the study health counselor. | Behavioural | Enhanced Lifestyle (eLI) |
Primary outcome
Mean weight change at 6 months
Time frame: 6 months
Weight in kg.
11 secondary outcomes
Change in physical activity
Time frame: 6 months
Change in blood pressure
Time frame: 6 months
Change in A1c
Time frame: 6 months
Change in lipids
Time frame: 6 months
Change in quality of life
Time frame: 6 months
Change in depression score
Time frame: 6 months
Change in diet quality
Time frame: 6 months
Breastfeeding
Time frame: 6 months
Adherence to Metformin treatment
Time frame: 4.5 to 5 months
Infant weight
Time frame: 6 months
Infant length
Time frame: 6 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Nov 2026.
- Background: PubMed 17596462Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007 Jul;30 Suppl 2:S141-6. doi: 10.2337/dc07-s206. No abstract available.
- Background: PubMed 24945238DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014 Jun 19;11:E104. doi: 10.5888/pcd11.130415.
- Background: PubMed 18463375HAPO Study Cooperative Research Group; Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008 May 8;358(19):1991-2002. doi: 10.1056/NEJMoa0707943.
- Background: PubMed 26459420Heida KY, Franx A, van Rijn BB, Eijkemans MJ, Boer JM, Verschuren MW, Oudijk MA, Bots ML, van der Schouw YT. Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus. Hypertension. 2015 Dec;66(6):1116-22. doi: 10.1161/HYPERTENSIONAHA.115.06005. Epub 2015 Oct 12.
- Background: PubMed 22619080Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012 Jul;35(7):1492-8. doi: 10.2337/dc11-2267. Epub 2012 May 22.
- Background: PubMed 19465232Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009 May 23;373(9677):1773-9. doi: 10.1016/S0140-6736(09)60731-5.
- Background: PubMed 16936160Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner J, Venditti B, Wylie-Rosett J. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006 Sep;29(9):2102-7. doi: 10.2337/dc06-0560.
- Background: PubMed 11832527Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512.
- Background: PubMed 7479629Elmer PJ, Grimm R Jr, Laing B, Grandits G, Svendsen K, Van Heel N, Betz E, Raines J, Link M, Stamler J, et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Prev Med. 1995 Jul;24(4):378-88. doi: 10.1006/pmed.1995.1062.
- Background: PubMed 11333990Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343-50. doi: 10.1056/NEJM200105033441801.
- Background: PubMed 9515998Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH Jr, Kostis JB, Kumanyika S, Lacy CR, Johnson KC, Folmar S, Cutler JA. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998 Mar 18;279(11):839-46. doi: 10.1001/jama.279.11.839.
- Background: PubMed 24861556Cassina M, Dona M, Di Gianantonio E, Litta P, Clementi M. First-trimester exposure to metformin and risk of birth defects: a systematic review and meta-analysis. Hum Reprod Update. 2014 Sep-Oct;20(5):656-69. doi: 10.1093/humupd/dmu022. Epub 2014 May 25.
- ACOG Statement on AMA Support for 12 Months of Postpartum Coverage Under MedicaidLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. The research team will share unidentified results of outcomes, including clinical and behavioral outcomes.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Wanda Nicholson, MD principal investigator
The George Washington University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Metformin Hcl 850Mg Tab, Lifestyle Intervention and Enhanced Lifestyle Intervention in people with Weight Loss and Gestational Diabetes Mellitus in Pregnancy, run by George Washington University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean weight change at 6 months (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06948825, which also lists 24 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Nov 2026.