Perspectives on Prevention of Type 2 Diabetes After Gestational Diabetes: A Qualitative Study of Hispanic, African-American and White Women

2014 ◽  
Vol 19 (7) ◽  
pp. 1526-1534 ◽  
Author(s):  
Joyce W. Tang ◽  
Krys E. Foster ◽  
Javiera Pumarino ◽  
Ronald T. Ackermann ◽  
Alan M. Peaceman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
White Women

scholarly journals Healthcare Professionals’ Perspectives on the Cross-Sectoral Treatment Pathway for Women with Gestational Diabetes during and after Pregnancy—A Qualitative Study

2021 ◽  
Vol 10 (4) ◽  
pp. 843
Author(s):  
Anne Timm ◽  
Karoline Kragelund Nielsen ◽  
Ulla Christensen ◽  
Helle Terkildsen Maindal
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Adverse Outcomes ◽  
Treatment Pathway ◽  
Healthy Behaviors ◽  
The Cross

Gestational diabetes mellitus (GDM) increases the risk of adverse outcomes during and after pregnancy, including a long-term risk of type 2 diabetes. Women with GDM are treated by numerous healthcare professionals during pregnancy and describe a lack of preventive care after pregnancy. We aim to investigate healthcare professionals’ perspectives on the cross-sectoral treatment pathway for women with GDM—during and after pregnancy. A qualitative study was conducted using systematic text condensation. Nine healthcare professionals (two general practitioners, four midwives, two obstetricians and one diabetes nurse) were interviewed and eight health visitors participated in two focus group discussions., Three major themes emerged: (1) “professional identities”, which were identified across healthcare professionals and shaped care practices; (2) ”unclear guidelines on type 2 diabetes prevention after GDM”, which contributed to uncertainty about tasks and responsibilities during and after pregnancy; and (3) “cross-sectoral collaboration”, which relied heavily on knowledge transfers between hospitals, general practice and the local municipality. The findings implicate that clear, transparent guidelines for all sectors should be prioritized to strengthen cross-sectoral care to women with GDM during and after pregnancy. As a result, strong cross-sectoral care throughout the GDM care pathway may improve maternal health by supporting healthy behaviors, facilitate weight loss and reduce the risk of subsequent GDM and early onset diabetes.

scholarly journals Genetic factors and risk of type 2 diabetes among women with a history of gestational diabetes: findings from two independent populations

2020 ◽  
Vol 8 (1) ◽  
pp. e000850 ◽  
Author(s):  
Mengying Li ◽  
Mohammad L Rahman ◽  
Jing Wu ◽  
Ming Ding ◽  
Jorge E Chavarro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
White Women ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Genome Wide Association Studies ◽  
Genetic Determinants ◽  
Increased Risk ◽  
History Of

ObjectiveWomen with a history of gestational diabetes mellitus (GDM) have an exceptionally high risk for type 2 diabetes (T2D). Yet, little is known about genetic determinants for T2D in this population. We examined the association of a genetic risk score (GRS) with risk of T2D in two independent populations of women with a history of GDM and how this association might be modified by non-genetic determinants for T2D.Research design and methodsThis cohort study included 2434 white women with a history of GDM from the Nurses’ Health Study II (NHSII, n=1884) and the Danish National Birth Cohort (DNBC, n=550). A GRS for T2D was calculated using 59 candidate single nucleotide polymorphisms for T2D identified from genome-wide association studies in European populations. An alternate healthy eating index (AHEI) score was derived to reflect dietary quality after the pregnancy affected by GDM.ResultsWomen on average were followed for 21 years in NHSII and 13 years in DNBC, during which 446 (23.7%) and 155 (28.2%) developed T2D, respectively. The GRS was generally positively associated with T2D risk in both cohorts. In the pooled analysis, the relative risks (RRs) for increasing quartiles of GRS were 1.00, 0.97, 1.25 and 1.19 (p trend=0.02). In both cohorts, the association appeared to be stronger among women with poorer (AHEI <median) than better dietary quality (AHEI ≥median), although the interaction was not significant. For example, in NHSII, the RRs across increasing quartiles of GRS were 1.00, 0.99, 1.51 and 1.29 (p trend=0.06) among women with poorer dietary quality and 1.00, 0.83, 0.81 and 0.94 (p trend=0.79) among women with better dietary quality (p interaction=0.11).ConclusionsAmong white women with a history of GDM, higher GRS for T2D was associated with an increased risk of T2D.

scholarly journals Chinese Women’s Attitudes Towards Postpartum Interventions to Prevent Type 2 Diabetes After Gestational Diabetes: A Semi-Structured Qualitative Study

2020 ◽  
Author(s):  
Jie Shang ◽  
Amanda Henry ◽  
Puhong Zhang ◽  
Huan Chen ◽  
Kelly Thompson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Family Members ◽  
Lifestyle Change ◽  
Blood Glucose Monitoring ◽  
Enabling Environment ◽  
Early Postpartum

Abstract Background: Gestational diabetes (GDM) is a global problem affecting millions of pregnant women, including in mainland China. These women are at high risk of Type II diabetes (T2DM). Cost-effective and clinically effective interventions are needed. We aimed to explore Chinese women’s perspectives, concerns and motivations towards participation in early postpartum interventions and/or research to prevent the development of T2DM after a GDM-affected pregnancy. Methods: We conducted a qualitative study in two hospitals in Chengdu, Southwest China. Face-to-face semi-structured interviews were conducted with 20 women with recent experience of GDM: 16 postpartum women and 4 pregnant women. Women were asked about their attitudes towards postpartum screening for type 2 diabetes, lifestyle interventions, mHealth delivered interventions and pharmacologic interventions (specifically metformin). An inductive approach to analysis was used. Interviews were recorded, transcribed, and coded using NVivo 12 Pro. Results: Most women held positive attitudes towards participating in T2DM screening, and were willing to participate in postpartum interventions to prevent T2DM through lifestyle change or mHealth interventions. Women were less likely to agree to pharmacological intervention, unless they had family members with diabetes or needed medication themselves during pregnancy. We identified seven domains influencing women’s attitudes towards future interventions: (1) experiences with the health system during pregnancy; (2) living in an enabling environment; (3) the experience of T2DM in family members; (4) knowledge of diabetes and perception of risk; (5) concerns about personal and baby health; (6) feelings and emotions, and (7) lifestyle constraints. Those with more severe GDM, an enabling environment and health knowledge, and with experience of T2DM in family members expressed more favourable views of postpartum interventions and research participation to prevent T2DM after GDM. Those who perceived themselves as having mild GDM and those with time/lifestyle constraints were less likely to participate.Conclusions: Women with experiences of GDM in Chengdu are generally willing to participate in early postpartum interventions and/or research to reduce their risk of T2DM, with a preference for non-drug, mHealth based interventions, integrating lifestyle change strategies, blood glucose monitoring, postpartum recovery and mental health.

scholarly journals Chinese women’s attitudes towards postpartum interventions to prevent type 2 diabetes after gestational diabetes: a semi-structured qualitative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jie Shang ◽  
Amanda Henry ◽  
Puhong Zhang ◽  
Huan Chen ◽  
Kelly Thompson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Family Members ◽  
Lifestyle Change ◽  
Blood Glucose Monitoring ◽  
Enabling Environment ◽  
Early Postpartum

Abstract Background Gestational diabetes (GDM) is a global problem affecting millions of pregnant women, including in mainland China. These women are at high risk of Type II diabetes (T2DM). Cost-effective and clinically effective interventions are needed. We aimed to explore Chinese women’s perspectives, concerns and motivations towards participation in early postpartum interventions and/or research to prevent the development of T2DM after a GDM-affected pregnancy. Methods We conducted a qualitative study in two hospitals in Chengdu, Southwest China. Face-to-face semi-structured interviews were conducted with 20 women with recent experience of GDM: 16 postpartum women and 4 pregnant women. Women were asked about their attitudes towards postpartum screening for type 2 diabetes, lifestyle interventions, mHealth delivered interventions and pharmacologic interventions (specifically metformin). An inductive approach to analysis was used. Interviews were recorded, transcribed, and coded using NVivo 12 Pro. Results Most women held positive attitudes towards participating in T2DM screening, and were willing to participate in postpartum interventions to prevent T2DM through lifestyle change or mHealth interventions. Women were less likely to agree to pharmacological intervention, unless they had family members with diabetes or needed medication themselves during pregnancy. We identified seven domains influencing women’s attitudes towards future interventions: (1) experiences with the health system during pregnancy; (2) living in an enabling environment; (3) the experience of T2DM in family members; (4) knowledge of diabetes and perception of risk; (5) concerns about personal and baby health; (6) feelings and emotions, and (7) lifestyle constraints. Those with more severe GDM, an enabling environment and health knowledge, and with experience of T2DM in family members expressed more favourable views of postpartum interventions and research participation to prevent T2DM after GDM. Those who perceived themselves as having mild GDM and those with time/lifestyle constraints were less likely to participate. Conclusions Women with experiences of GDM in Chengdu are generally willing to participate in early postpartum interventions and/or research to reduce their risk of T2DM, with a preference for non-drug, mHealth based interventions, integrating lifestyle change strategies, blood glucose monitoring, postpartum recovery and mental health.

scholarly journals The low-risk perception of developing type 2 diabetes among women with a previous history of gestational diabetes: a qualitative study

2019 ◽  
Vol 36 (1) ◽  
pp. 15-19b
Author(s):  
Manisha Sharma ◽  
Tejpal Singh Purewal ◽  
Stephen Fallows ◽  
Lynne Kennedy
Keyword(s):  
Type 2 Diabetes ◽  
Risk Perception ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Previous History ◽  
Low Risk ◽  
History Of

scholarly journals Reducing risk of type 2 diabetes after gestational diabetes: a qualitative study to explore the potential of technology in primary care

2018 ◽  
Vol 68 (669) ◽  
pp. e260-e267 ◽  
Author(s):  
Brian McMillan ◽  
Katherine Easton ◽  
Elizabeth Goyder ◽  
Brigitte Delaney ◽  
Priya Madhuvrata ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Secondary Care ◽  
Future Research ◽  
Increased Risk ◽  
Risk Of Progression

BackgroundDespite the seven-fold increased risk of type 2 diabetes mellitus (T2DM) among females previously diagnosed with gestational diabetes (GD), annual rates of follow-up in primary care are low. There is a need to consider how to reduce the incidence of progression to T2DM among this high-risk group.AimTo examine the views of females diagnosed with GD to ascertain how to improve primary care support postnatally, and the potential role of technology in reducing the risk of progression to T2DM.Design and settingA qualitative study of a purposive sample of 27 postnatal females leaving secondary care with a recent diagnosis of GD.MethodSemi-structured interviews were conducted with 27 females, who had been previously diagnosed with GD, at around 6–12 weeks postnatally. Interviews were audiotaped, transcribed, and analysed thematically.ResultsFacilitators and barriers to engaging in a healthy postnatal lifestyle were identified, the most dominant being competing demands on time. Although females were generally satisfied with the secondary care they received antenatally, they felt abandoned postnatally and were uncertain what to expect from their GP in terms of follow-up and support. Females felt postnatal care could be improved by greater clarity regarding this, and enhanced by peer support, multidisciplinary input, and subsidised facilities. Technology was seen as a potential adjunct by providing information, enabling flexible and personalised self-management, and facilitating social support.ConclusionA more tailored approach for females previously diagnosed with GD may help reduce the risk of progression to T2DM. A need for future research to test the efficacy of using technology as an adjunct to current care was identified.

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