The Project Wellness Pilot Feasibility Randomized Controlled Trial

Inclusion Criteria: * Age 18-40 years * Singleton viable pregnancy with low suspicion for clinically significant abnormality or aneuploidy * Hyperglycemia after 24 weeks identified by: One step diagnostic procedure 75-g Oral Glucose Tolerance Test (OGTT) after an overnight fast, with plasma glucose measured fasting and at 1 and 2 hrs, and any of the following plasma glucose values are met or exceeded: Fasting: 92 mg/dL (5.1 mmol/L) 1. hr: 180 mg/dL (10.0 mmol/L) 2. hr: 153 mg/dL (8.5 mmol/L) For the Two step diagnostic procedure, only Step 1 (i.e., at risk for GDM) is required for eligibility: Step 1: 50-g glucose screening test (non-fasting), with plasma glucose measured at 1-hr ≥130 mg/dL Any other abnormal value on oral glucose tolerance testing associated with macrosomia * English speaker and comfortable completing surveys in English (i.e., no translator needed) * Planning to remain in the area for baby's first year Exclusion Criteria: * Previously diagnosed with diabetes (i.e., Type I or Type II diabetes) outside of pregnancy * Contraindications to exercise (i.e., absolute contraindications according to published recommendations for exercise during pregnancy), as follows: Hemodynamically significant heart disease, Restrictive lung disease, Incompetent cervix/cerclage, Persistent second or third trimester bleeding, Placenta previa or vasa previa after 26 weeks gestation, Premature labor during the current pregnancy, Ruptured membranes, Preeclampsia/pregnancy-induced hypertension, severe anemia * Currently non-smoker * Current illicit drug use * Current use of daily medications known to alter insulin resistance and metabolic profiles (e.g., metformin, corticosteroids, anti-psychotics) * Currently taking medication for polycystic ovarian syndrome (PCOS) (i.e., history of PCOS okay as long as she is not currently taking medication for PCOS)