A mother-infant intervention for women with previous gestational diabetes (TANGO)
Developing and testing the feasibility of a mother–infant dyad intervention for women with Gestational diabetes to reduce the risk of type 2 diabetes (TANGO).
Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy when blood sugar levels become too high. It affects around 1 in 10 pregnancies and requires careful management to prevent complications for mother and baby.
It usually goes away when the baby is born; however, half of women with GDM will go on to develop type 2 diabetes (T2D) within 10 years, and their children also have a higher risk of obesity and diabetes later in life. GDM is also linked to other challenges in the postnatal period including low mood, distress, and difficulties with breastfeeding and recovery.
Health programmes for women after GDM have focused on diet and physical activity to reduce the risk of type 2 diabetes. But women have said they are difficult to take part in as they often overlook barriers in the postnatal period including the competing demands of motherhood, poor mental health, lack of sleep, limited social support and a tendency to prioritise infant care over maternal care.
Aims
The TANGO study aims to co-develop and test a new programme that supports women and their babies after a pregnancy affected by GDM. By focusing on both members of the mother–infant dyad, TANGO seeks to promote physical, psychological, and relational wellbeing together.
Methods
TANGO is organised into three work packages:
- Understanding women’s experiences:
- Women will be interviewed from diagnosis of GDM through to one year after birth to explore their experiences, needs, and the best times to offer support.
- Co-designing the intervention:
- Working with women with lived experience, alongside input from healthcare professionals, the team will design a mother-baby programme that promotes both physical and mental health after GDM.
- Testing the programme:
- The new intervention will be tested for feasibility to see how it can fit within real-world NHS maternity and diabetes care.
Impact
Why this matters
Women who have experienced GDM often describe feeling overlooked once their baby is born, despite facing physical and emotional challenges that can affect both their health and their baby’s development. It can be difficult to engage with health programmes after birth due to the demands of caring for a new baby, tiredness, breastfeeding, and mental health.
By involving both mother and baby, the TANGO programme aims to be more accessible, motivating, and culturally inclusive, and responsive to women’s real postnatal lives to supports women’s wellbeing while also reducing long-term diabetes risk.
Working with women and families
TANGO has been developed alongside a dedicated Patient and Public Involvement and Engagement (PPIE) group of women who have experienced GDM. This group meets regularly to guide all stages of the research, from shaping questions and methods to co-producing materials and planning how to share results.
A Design Group of 12 women are working closely to design the mother-baby programme with input from experts in diabetes, psychology, psychiatry, public health, and policy.
Principal Investigator
NIHR Advanced Fellow in Perinatal Psychology