Research Summary
Analyzed using Evidence Intelligence™

Shared decision making improves diabetes prevention in women with gestational diabetes

Last updated September 9, 2026

Key finding

The primary outcome is the proportion of participants who lose ≥5% body weight at 12 months.

The GRAND study evaluated the impact of shared decision making on diabetes prevention among participants with gestational diabetes. Results indicated unclear effectiveness in achieving weight loss and other outcomes.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

The GRAND study evaluated the impact of shared decision making on diabetes prevention among participants with gestational diabetes. Results indicated unclear effectiveness in achieving weight loss and other outcomes.

Clinical relevance

Understanding the effectiveness of shared decision making in diabetes prevention is crucial for developing strategies that can help individuals at risk. If proven effective, such interventions could significantly reduce the incidence of type 2 diabetes in populations with a history of gestational diabetes, ultimately improving health outcomes and reducing healthcare costs.

Keep in mind

Unclear effectiveness of interventions due to lack of specific effect sizes. Limited generalizability due to the specific population studied. Potential unmeasured confounders affecting outcomes.

Published in

Journal Reference

Publication details and source links for this paper.

Ruth M, Amanda V, Felicia C, et al. Gestational diabetes Risk Attenuation for New Diabetes (GRAND) study: A pragmatic randomized controlled trial of shared decision making for diabetes prevention. Contemporary clinical trials. 2023;124:107007-107007. doi:10.1016/j.cct.2022.107007

Main Effects

Proportion of participants achieving ≥5% weight loss at 12 months: unclear effectiveness.

Proportion of participants achieving ≥5% weight loss at 24 months: unclear effectiveness.

Uptake of DPP lifestyle program or metformin: unclear effectiveness.

Patient activation and health-related quality of life: unclear effectiveness.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Telephone-based pharmacist behavioral intervention and Annual follow-up screening for progression to T2DM, Health-related quality of life, Patient Activation, and 3 more.

Primary intervention

Telephone-based pharmacist behavioral intervention

Primary outcomes

  • Annual follow-up screening for progression to T2DM
  • Health-related quality of life
  • Patient Activation

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

6
Evidence pairs
6
Relationships
3
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 68

3

Related topics

6

Evidence pairs

560

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 6 evidence relationships
  • Includes primary outcome data
  • Linked to 3 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Quality of Life Outcomes

Related evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Weight Loss Outcomes

Save evidence

Evidence topic

Quality of Life

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

Annual follow-up screening for progression to T2DM

Telephone-based pharmacist behavioral intervention → Annual follow-up screening for progression to T2DM

Telephone-based pharmacist behavioral intervention → Annual follow-up screening for progression to T2DM

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Health-related quality of life

Telephone-based pharmacist behavioral intervention → Health-related quality of life

Telephone-based pharmacist behavioral intervention → Health-related quality of life

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Patient Activation

Telephone-based pharmacist behavioral intervention → Patient Activation

Telephone-based pharmacist behavioral intervention → Patient Activation

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Rates of GDM in a subsequent pregnancy

Telephone-based pharmacist behavioral intervention → Rates of GDM in a subsequent pregnancy

Telephone-based pharmacist behavioral intervention → Rates of GDM in a subsequent pregnancy

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Uptake of DPP lifestyle program or metformin

Telephone-based pharmacist behavioral intervention → Uptake of DPP lifestyle program or metformin

Telephone-based pharmacist behavioral intervention → Uptake of DPP lifestyle program or metformin

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Weight loss at 6 months

Telephone-based pharmacist behavioral intervention → Weight loss at 6 months

Telephone-based pharmacist behavioral intervention → Weight loss at 6 months

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Evidence Library

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evidence suggest

Evidence Suggest

  • The study included two arms: shared decision making and control.
  • Primary outcome focused on weight loss at 12 months.
  • Secondary outcomes included lifestyle program uptake and patient activation.
who this applies

Who this applies to

  • Individuals with a history of gestational diabetes.
  • Participants interested in diabetes prevention strategies.
keep in mind

Keep in Mind

  • Results are based on unclear effectiveness, limiting conclusions.
  • Findings may not be applicable to broader populations outside the study group.
  • Further research is needed to clarify the effectiveness of shared decision making.
between the lines

Between the Lines

  • Unclear effectiveness of interventions due to lack of specific effect sizes.
  • Limited generalizability due to the specific population studied.
  • Potential unmeasured confounders affecting outcomes.

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and Annual follow-up screening for progression to T2DM, Diabetes Self-Management Education and Support (DSMES) Programs and Quality of Life Outcomes.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

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Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Do Diabetes Self-Management Education and Support (DSMES) Programs improve quality of life outcomes?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs appear to improve quality of life outcomes.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Health-related quality of life

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 14 supporting studies with generally consistent results and a positive effect signal.

14 supporting studies

Do Diabetes Self-Management Education and Support (DSMES) Programs affect weight loss outcomes?

Moderate Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may affect weight loss outcomes.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Weight loss at 6 months

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

  • Only a small number of supporting studies are available.
2 supporting studies

Does Telephone-based pharmacist behavioral intervention improve annual follow-up screening for progression to t2dm?

Emerging Evidence

Telephone-based pharmacist behavioral intervention appears to improve annual follow-up screening for progression to t2dm.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Annual follow-up screening for progression to T2DM

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Telephone-based pharmacist behavioral intervention improve patient activation?

Emerging Evidence

Telephone-based pharmacist behavioral intervention appears to improve patient activation.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Patient Activation

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
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