scholarly journals Experiences of lifestyle change among women with gestational diabetes mellitus (GDM): A behavioural diagnosis using the COM-B model in a low-income setting

PLoS ONE ◽  
2019 ◽  
Vol 14 (11) ◽  
pp. e0225431 ◽  
Author(s):  
Lorrein Shamiso Muhwava ◽  
Katherine Murphy ◽  
Christina Zarowsky ◽  
Naomi Levitt
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Low Income ◽  
Lifestyle Change ◽  
Low Income Setting

Abstract P051: Lifestyle Change In Mid-life And Long-term Weight Gain In Women With And Without History Of Gestational Diabetes Mellitus

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jiaxi Yang ◽  
Janet Rich-Edwards ◽  
Molin Wang ◽  
Wafaie W Fawzi ◽  
Cuilin Zhang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Body Weight ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Weight Change ◽  
Lifestyle Change ◽  
History Of

Introduction: Identifying strategies to mitigate gradual long-term weight gain is critical for preventing obesity and its related chronic diseases, particularly for persons at high risk, such as women with a history of gestational diabetes mellitus (GDM). We prospectively examined the independent associations between lifestyle changes in mid-life with long-term weight change among women with and without a history of GDM. Hypothesis: We hypothesized that favorable improvements in lifestyle would be associated with less long-term weight gain, particularly among women with a history of GDM. Methods: We used data from the longitudinal Nurses’ Health Study II, with self-reported lifestyle, diet via food frequency questionnaire, and body weight updated every 2-4 years. We analyzed repeated 4-year changes of the following lifestyle factors among parous women after age 40: adherence to a healthy dietary pattern (Alternate Healthy Eating Index score [AHEI]), physical activity (MET-hrs/wk), moderate alcohol intake (servings/d), and non-smoking, in relation to concurrent 4-year change in body weight (lb). We used multivariable generalized estimating equation models to estimate the least-squares mean of 4-year weight change and 95% confidence interval (CI) for each lifestyle change category (e.g., decrease, remain stable, and increase). Results: Our analysis included 61,637 women, of which 3,444 (5.6%) had a history of GDM. Mean of repeated 4-year weight change after age 40 was 3.0 lb (SD=14.3). Improving diet was associated with favorable 4-year weight change, particularly among women with a history of GDM vs. without GDM (AHEI score change from low to high: -6.3 lb [CI: -9.3, -3.4] vs. -2.7 lb [CI: -3.2, -2.2], respectively; p-interaction=0.04). Increasing physical activity was associated with weight maintenance for GDM women only (MET-hrs/wk change from low to high: 0.6 lb [95% CI: -0.6, 1.7] vs. 2.0 lb [95% CI: 1.8, 2.2] for GDM vs. non-GDM, respectively; p-interaction=0.01). Reducing alcohol (decreased servings/d: 1.9 lb [95% CI: 1.2, 2.6] and 2.8 lb [95% CI: 2.6, 2.9] for GDM vs. non-GDM, respectively) and smoking cessation (recent quitter: 9.8 lb [95% CI: 7.1, 12.5] and 8.5 lb [95% CI: 8.0, 9.1] for GDM vs. non-GDM, respectively) were associated with similar patterns in weight change for women with and without prior GDM. Further, the joint association of improving both diet and physical activity from low to high was related to -12.3 lb (95% CI: -19.5, -5.0) and -6.1 lb (95% CI: -8.0, -4.2) of weight loss for GDM vs. non-GDM women, respectively. Conclusions: We observed that attainable improvements in diet quality and physical activity were associated with weight gain prevention. These findings support continued efforts to improve lifestyle as a beneficial strategy to prevent long-term weight gain, particularly among women with a history of GDM.

scholarly journals A simplified diagnostic work-up for the detection of gestational diabetes mellitus in low resources settings: achievements and challenges

2020 ◽  
Vol 302 (5) ◽  
pp. 1127-1134
Author(s):  
Giovanni Putoto ◽  
Edgardo Somigliana ◽  
Federico Olivo ◽  
Simona Ponte ◽  
Michael Momoh Koroma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Low Income ◽  
Tolerance Test ◽  
Low Income Countries ◽  
Oral Glucose ◽  
Capillary Glucose ◽  
Working Day ◽  
Diagnostic Work

Abstract Purpose Modern strategies for the screening and diagnosis of Gestational Diabetes Mellitus (GDM) rely on universal Oral Glucose Tolerance Test (OGTT). However, they are unsustainable in low-income countries. In this study, we aimed at assessing the feasibility of a simplified diagnostic policy. Methods The study took place in an urban referral hospital in Freetown, Sierra Leone. During an 11-month period, pregnant women were offered capillary blood test for glucose assessment. They could be screened at any time during pregnancy. GDM was diagnosed if fasting glucose was ≥ 92 mg/dl or if the OGTT was positive. The latter was prescribed only to women presenting after 24 weeks’ gestation with at least one risk factor for GDM and fasting capillary glucose between 85 and 91 mg/dl. A definitive diagnosis required confirmation to this aim, women with values above the thresholds were invited to refer the next working day for repeating the test after fasting overnight. Results Overall, 7827 women were referred for screening, of whom 6872 (87%) underwent at least one capillary glucose assessment. However, 895 of those who had a positive test did not return for confirmation. Overall, a definite assessment could be done in 5799 subjects corresponding to 76% (95% CI 75–77%) of those eligible. GDM was diagnosed in 128 women (1.9%, 95% CI 1.6–2.2%). Based on an expected confirmation rate of 22% (calculated from those who referred for confirmation) in the 895 women who did not come back, one could infer that GDM would have been diagnosed in additional 197 women, raising the prevalence to 4.7% (95% CI 4.2–5.3%). Conclusion Three quarters of subjects could be assessed with our approach. Data also suggest that GDM is not rare even if identification of affected cases remains challenging.

scholarly journals An Exploratory Analysis of Factors Associated with Low Risk Perception for Developing Type 2 Diabetes amongst Low-income, Primarily Latina Women with prior Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Priyanka Athavale ◽  
Ndola Prata ◽  
Karen Sokal-Gutierrez ◽  
Maureen Lahiff ◽  
Adriana Najmabadi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Perception ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Low Income ◽  
Lower Risk ◽  
Post Partum ◽  
Latina Women ◽  
Migrant Status ◽  
Spanish Speaking

Abstract Background: Gestational diabetes mellitus (GDM) is a significant contributor to the development of diabetes (DM2) post-partum, with higher rates amongst low-income and Latina women. Understanding one’s risk perception for developing DM2 postpartum amongst women with GDM can help target preventive interventions that promote positive health behaviors and lifestyle changes. This study aims to assess how the interplay of individual level factors, healthcare based factors, and structural factors influence risk perception for developing DM2 amongst low-income, primarily migrant Latina women with recent gestational diabetes mellitus. Methods: Data is from the baseline assessment of the STAR MAMA intervention. Women (N=171) receiving prenatal care at low-income urban clinics in San Francisco Bay Area were surveyed for basic demographics, healthcare access, and health-related behaviors. The outcome variable, risk perception for developing DM2 post-partum, was measured using the RPS-DM tool. Associations between risk perception for developing DM2 and individual, health-care based and structural (eg. health insurance, food insecurity, educational attainment) covariates were estimated using descriptive statistics and logistic regression. Results: Although all participants had a high risk for subsequently developing DM2, 76% reported lower risk perception for developing diabetes within the next 1, 5, and 10 years. Migrant status, less than high school education, and food insecurity were associated with lower risk perception (p<0.05). Spanish-speaking women with GDM who did not have family histories of DM2 were at greatest risk of underestimating their DM2 risk (OR=6.5; CI= (1.149, 11.795)). On the other hand, Spanish-speaking women who had family histories of DM2 were more likely to correctly assess their DM2 risk (OR=0.16; CI= (0.031, 0.824)). Conclusions: Structural and individual factors, rooted in migrant status and cultural backgrounds, influence personal risk perception. The majority of high-risk GDM women in this sample underestimate their risk for developing diabetes. This poses an opportunity for the healthcare system to improve patient-provider communication to improve risk perceptions and motivation for behavioral risk reduction. Improved counseling regarding risk perception for vulnerable, migrant populations with GDM is critical to accurately convey risk and engage individuals in preventive behaviors. Trial Registration: The clinical trial registration number is: NCT02240420 and date of registration: 9/11/2014.

scholarly journals Women’s Views on Their Diagnosis and Management for Borderline Gestational Diabetes Mellitus

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Shanshan Han ◽  
Philippa F. Middleton ◽  
Tanya K. Bubner ◽  
Caroline A. Crowther
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Change ◽  
Lifestyle Changes ◽  
Future Health ◽  
Face To Face ◽  
Diagnosis And Management ◽  
Semistructured Interviews ◽  
Women’S Views

Introduction. Little is known about women’s views relating to a diagnosis of borderline gestational diabetes mellitus (GDM) and the subsequent management. This study aimed to explore women’s experiences after being diagnosed with borderline GDM, their attitudes about treatment, and factors important to them for achieving any lifestyle changes.Methods. We conducted face-to-face, semistructured interviews with women diagnosed with borderline GDM.Results. A total of 22 women were interviewed. After a diagnosis of borderline GDM, 14 (64%) women reported not being concerned or worried. Management of borderline GDM was thought by 21 (95%) women to be very important or important. Eighteen (82%) women planned to improve their diet and/or exercise to manage their borderline GDM. The most frequently mentioned enabler for achieving intended lifestyle change was being more motivated to improve the health of their baby and/or themselves (15 women). The most frequent barrier was tiredness and/or being physically unwell (11 women).Conclusions. A diagnosis of borderline GDM caused some concern to one-third of women interviewed. The majority of women believed managing their borderline GDM was important and they planned to improve their lifestyle. Women’s own and their babies’ future health were powerful motivators for lifestyle change.

scholarly journals Physical activity pattern in early pregnancy and gestational diabetes mellitus risk among low-income women: A prospective cross-sectional study

2019 ◽  
Vol 7 ◽  
pp. 205031211987592
Author(s):  
Graciliano Ramos do Nascimento ◽  
Maria do Carmo Borges ◽  
José Natal Figueiroa ◽  
Lucas Victor Alves ◽  
João Guilherme Alves
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Low Income ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Income Women

Objective: Gestational diabetes mellitus is increasing worldwide, mainly in developing countries, and physical activity has not been studied in gestational diabetes mellitus prevention among low-income population. This prospective cross-sectional study assessed the gestational diabetes mellitus risk related to physical activity in early pregnancy among low-income women. Methods: A prospective cross-sectional study with 544 low-income pregnant women was conducted at the Instituto de Medicina Integral Prof. Fernando Figueira, Brazil. Gestational diabetes mellitus was diagnosed using the International Association of Diabetes and Pregnancy Study Groups criteria. Physical activity was assessed during early pregnancy using the Pregnancy Physical Activity Questionnaire and categorized as sedentary, light, moderate, or vigorous intensity. Results: Gestational diabetes mellitus occurred in 95 of 544 women (17.4%). Body mass index was higher in the gestational diabetes mellitus group. Nearly half of all pregnant women studied were physically inactive, and none of them were classified as vigorous physical active. Sedentary physical activity pattern was associated with a higher odds of gestational diabetes mellitus (odds ratio = 1.8, 95% confidence interval = 1.1–2.9), which did not change after adjusting for several covariates (odds ratio = 1.9, 95% confidence interval = 1.2–3.1). Conclusion: Physical inactivity in early pregnancy is associated with a higher risk of gestational diabetes mellitus among low-income women.

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