scholarly journals Development and Validation of an Online Survey to Assess Perception of Diabetes Risk and Barriers and Facilitators to Weight Loss Following Gestational Diabetes

2021 ◽  
Vol 18 (2) ◽  
pp. 480
Author(s):  
Kristy L. Gray ◽  
Mayya Grebenshchikova ◽  
Sharleen L. O’Reilly ◽  
Lois McKellar ◽  
Peter M. Clifton ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Theoretical Domains Framework ◽  
Diabetes Risk ◽  
Expert Evaluation ◽  
Content Validation ◽  
Pilot Testing ◽  
Response Options ◽  
Expert Review ◽  
Development And Validation

Our objective was to describe the development and validation of a survey investigating barriers to weight loss, perception of diabetes risk, and views of diet strategies following gestational diabetes (GDM). The survey underwent three stages of development: generation of items, expert evaluation, and pilot testing. A content validation index (CVI) was calculated from expert responses regarding item relevance, coherence, clarity, and response options. Experts also responded to the domain fit of questions linked to the Theoretical Domains Framework (TDF). Pilot responders answered the survey and responded to review questions. Six experts in the field of nutrition, midwifery, psychology, or other health or medical research completed the expert review stage of the survey. In the pilot test, there were 20 responders who were women with previous GDM and who were living in Australia. The overall CVI from the expert review was 0.91. All questions except one received an I-CVI of >0.78 for relevance (n = 35). Fourteen of the 27 items linked to the TDF received an agreement ratio of <1.0. Twenty-seven of the 31 pilot questions were completed by ≥90% of responders. Pilot review questions revealed an agreement percentage of ≥86% (n = 12) regarding the survey’s ease to complete, understand, importance, length, and interest level. The final survey tool consists of 30 items and achieved content validation through expert evaluation and pilot testing.

scholarly journals Women's Barriers to Weight Loss, Knowledge of Future Diabetes Risk and Opinions of Diet Strategies Following Gestational Diabetes: An Online Survey (OR08-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kristy Gray ◽  
Maya Grebenshchikova ◽  
Sharleen O'Reilly ◽  
Lois McKellar ◽  
Peter Clifton ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Online Survey ◽  
South Australia ◽  
Theoretical Domains Framework ◽  
Energy Restriction ◽  
The Internet ◽  
Cross Sectional ◽  
Family Responsibilities ◽  
Expert Review

Abstract Objectives Weight loss after gestational diabetes (GDM) significantly reduces the risk of developing type 2 diabetes (T2DM) however weight loss is not easily achieved or maintained. The purpose of this survey was to examine knowledge of future risk of T2DM after GDM, barriers to weight loss and to identify diet strategies that these women feel might work for them. Opinions of intermittent energy restriction (IER) were of particular interest. Methods Australian women aged ≥18 years who ever had GDM were invited to participate in this cross-sectional online survey. The survey was developed by a dietitian using the Theoretical Domains Framework and underwent expert review (n = 6) and piloted (n = 20) prior to the final survey being run. Results There were 429 partial and 328 complete responses (age 37.2 ± 7.2 years, n = 429, years post GDM 4.9 ± 6.3 years, n = 428, BMI 30.9 ± 7.3 kg/m2n = 394). Overweight (n = 110) or obese (n = 200) responders mostly knew they were overweight and three-quarters thought they were either high (n = 144, 33.6%) or moderate risk (n = 176, 41.1%) for developing T2DM. Most women reported they knew what sorts of food to eat to lose weight (n = 332, 86.7%), that their families would support them (n = 320, 87%) and they were motivated to lose weight (n = 213, 58.4%). The most common barriers were family responsibilities taking priority (n = 240, 63%) and finding it hard to deal with hunger (n = 206, 55.8%). Weight loss programs by a dietitian were popular as individual appointments (n = 242, 65.1%) or an online program (n = 200, 53.5%). Nearly three-quarters of responders had or would use the internet to seek weight loss information (n = 308, 71.8%). Exercising was the most tried method of weight loss (n = 234, 71.1%). Most women had heard of IER (the “5:2 diet”) (n = 284, 73%) but only 34 had tried the diet. Of the women who hadn't heard of the 5:2 diet, 51.5% (n = 52) answered that it sounded like a good option and 15.8% (n = 16) didn't think the diet would suit them. Conclusions Despite most women reporting knowledge of their risk of T2DM, motivation to lose weight and family support, family responsibilities can make weight loss efforts difficult for mothers. Exercising, the 5:2 diet and use of the internet is an appealing option for some women however individual circumstances should be taken into consideration. Funding Sources The University of South Australia.

The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial

2021 ◽  
Author(s):  
Kristy L Gray ◽  
Peter M Clifton ◽  
Jennifer B Keogh
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Serum Insulin ◽  
Dropout Rate ◽  
Energy Restriction ◽  
Diabetes Risk ◽  
Oral Glucose ◽  
Risk Markers ◽  
Overweight Women ◽  
The Mean

ABSTRACT Background Weight loss after gestational diabetes (GDM) can prevent or delay the onset of type 2 diabetes. Intermittent energy restriction (IER) may offer an alternative to continuous energy restriction (CER) for weight loss. Objectives We compared the effects of IER (2 days per week) to daily CER over 12 mo on weight loss and diabetes risk markers in overweight women with previous GDM. Methods Overweight females (n = 121) ≥18 y were randomized 1:1 to either IER [2-d 500 kcal (2100 kJ); n = 61] or CER [1500 kcal (6000 kJ); n = 60] in this 12-mo noninferiority trial. Results The trial was completed by 62 participants with a median age of 39.6 y [Quartile (Q) 1 to Quartile 3, 34.9 to 43.9 y] with a median BMI of 32.6 kg/m2 (Q1 to Q3, 28.5 to 37.9 kg/m2) at a median of 2.9 y after GDM (Q1 to Q3, 2.1 to 6.4 y; 49% attrition; IER n = 29; CER n = 30; P = 0.8). The mean ± SD weight loss was significant over time (P &lt; 0.001) but not by diet group (IER −4.8 ± 5.0 kg; CER −3.2 ± 5.0; P = 0.2). The mean between-group difference was −1.6 kg (95% CI: −4.2 to 1.0 kg; P = 0.2). There were no significant between-group differences in change in HbA1c, fasting plasma glucose, fasting serum insulin, HOMA-IR or 2-h oral glucose tolerance at 12 mo (p&gt;0.05). The trial was registered at https://www.anzctr.org.au/ (ACTRN12617001476325). Conclusions IER produces comparable weight loss to CER over 12 mo in overweight women with previous GDM. The high dropout rate in this study is a limitation in the interpretation of these results. Larger studies are needed to confirm noninferiority of IER compared to CER.

scholarly journals Weight Loss Barriers and Dietary Quality of Intermittent and Continuous Dieters in Women with a History of Gestational Diabetes

2021 ◽  
Vol 18 (19) ◽  
pp. 10243
Author(s):  
Kristy L. Gray ◽  
Peter M. Clifton ◽  
Jennifer B. Keogh
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Secondary Analysis ◽  
Theoretical Domains Framework ◽  
Energy Restriction ◽  
Dietary Quality ◽  
Behavioral Regulation ◽  
History Of ◽  
Regulation Strategies

Weight-loss after gestational diabetes (GDM) lowers the risk of type-2 diabetes (T2DM). Intermittent energy restriction (IER) produces comparable weight-loss to continuous energy restriction (CER), but long-term adherence remains difficult in this population. This exploratory secondary analysis of a 12-month trial comparing IER to CER following GDM examined weight-loss and dietary quality associated with barriers to weight-loss or T2DM risk perception as assessed in a Likert scale questionnaire at baseline. The participants had a median (IQR) BMI of 32.6 (9.4) kg/m2 and 3 (4) years postpartum (n = 121). Forty-five percent (n = 54) of the participants thought they were at a high risk of developing T2DM. Greater affordability of healthy food was related with greater weight-loss at 3 months (p = 0.044, n = 85). At 12 months, there was no significant relationship between weight-loss and the barriers to weight-loss (p > 0.05). CER had superior improvement in dietary quality at 12 months (CER 11 ± 10, IER 6 ± 5.6, n = 42, p = 0.05). Under the Theoretical Domains Framework, the barriers were predominantly related to behavioral regulation (n = 83, 69%; n = 76, 63%) and environmental context and resources (n = 67, 56%). Interventions for diabetes prevention in this population should include behavioral regulation strategies, consider the family home environment, and ensure that the risk of T2DM is conveyed. Women choosing IER may benefit from education to improve their dietary quality.

scholarly journals Women’s Barriers to Weight Loss, Perception of Future Diabetes Risk and Opinions of Diet Strategies Following Gestational Diabetes: An Online Survey

2020 ◽  
Vol 17 (24) ◽  
pp. 9180
Author(s):  
Kristy L. Gray ◽  
Lois McKellar ◽  
Sharleen L. O’Reilly ◽  
Peter M. Clifton ◽  
Jennifer B. Keogh
Keyword(s):  
Weight Loss ◽  
High Risk ◽  
Gestational Diabetes ◽  
Family Environment ◽  
Online Survey ◽  
Theoretical Domains Framework ◽  
Energy Restriction ◽  
Cross Sectional ◽  
Behavioural Regulation

Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM); however, weight loss remains challenging in this population. In order to explore perceptions of T2DM risk, barriers to weight loss, and views of diet strategies in women with previous GDM, a cross-sectional online survey of n = 429 women in Australia aged ≥18 years with previous GDM was conducted. Opinions of intermittent energy restriction (IER) were of interest. Seventy-five percent of responders (n = 322) had overweight or obesity, and 34% (n = 144) believed they had a high risk of developing T2DM. Within the Theoretical Domains Framework, barriers to weight loss were prominently related to Environmental Context and Resources, Beliefs about Capabilities, and Behavioural Regulation. Exercising was the most tried method of weight loss over other diet strategies (71%, n = 234) and weight loss support by a dietician was appealing as individual appointments (65%, n = 242) or an online program (54%, n = 200). Most women (73%, n = 284) had heard of IER (the “5:2 diet”), but only 12% (n = 34) had tried it. Open comments (n = 100) revealed mixed views of IER. Women in Australia with previous GDM were found to lack a self-perceived high risk of developing T2DM and expressed barriers to weight loss related to their family environment, beliefs about their capabilities and behavioural regulation. IER is appealing for some women with previous GDM; however, views vary.

195-LB: How Does a Prepregnancy Weight Loss Program Affect Gestational Diabetes Risk?

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 195-LB
Author(s):  
ERIN S. LEBLANC ◽  
NING SMITH ◽  
KIMBERLY VESCO ◽  
ANA G. ROSALES ◽  
VICTOR J. STEVENS
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Weight Loss Program ◽  
Diabetes Risk ◽  
Prepregnancy Weight

1386-P: Long-Term Weight Change after Pregnancy and Type 2 Diabetes Risk in Women with a History of Gestational Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1386-P
Author(s):  
SYLVIA E. BADON ◽  
FEI XU ◽  
CHARLES QUESENBERRY ◽  
ASSIAMIRA FERRARA ◽  
MONIQUE M. HEDDERSON
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Weight Change ◽  
Diabetes Risk ◽  
History Of

scholarly journals Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 408
Author(s):  
Sumali S. Hewage ◽  
Xin Yu Hazel Koh ◽  
Shu E. Soh ◽  
Wei Wei Pang ◽  
Doris Fok ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tolerance Test ◽  
Diabetes Risk ◽  
Breastfeeding Duration ◽  
Oral Glucose ◽  
Inverse Association ◽  
Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

scholarly journals The Development of a Paediatric Phoneme Discrimination Test for Arabic Phonemic Contrasts

2021 ◽  
Vol 11 (2) ◽  
pp. 150-166
Author(s):  
Hanin Rayes ◽  
Ghada Al-Malky ◽  
Deborah Vickers
Keyword(s):  
Closed Set ◽  
Retest Reliability ◽  
Response Options ◽  
Phoneme Discrimination ◽  
Significant Difference ◽  
Age Appropriate ◽  
Hearing Children ◽  
Test Retest Reliability ◽  
Development And Validation ◽  
Arabic Speaking

Objective: The aim of this project was to develop the Arabic CAPT (A-CAPT), a Standard Arabic version of the CHEAR auditory perception test (CAPT) that assesses consonant perception ability in children. Method: This closed-set test was evaluated with normal-hearing children aged 5 to 11 years. Development and validation of the speech materials were accomplished in two experimental phases. Twenty-six children participated in phase I, where the test materials were piloted to ensure that the selected words were age appropriate and that the form of Arabic used was familiar to the children. Sixteen children participated in phase II where test–retest reliability, age effects, and critical differences were measured. A computerized implementation was used to present stimuli and collect responses. Children selected one of four response options displayed on a screen for each trial. Results: Two lists of 32 words were developed with two levels of difficulty, easy and hard. Assessment of test–retest reliability for the final version of the lists showed a strong agreement. A within-subject ANOVA showed no significant difference between test and retest sessions. Performance improved with increasing age. Critical difference values were similar to the British English version of the CAPT. Conclusions: The A-CAPT is an appropriate speech perception test for assessing Arabic-speaking children as young as 5 years old. This test can reliably assess consonant perception ability and monitor changes over time or after an intervention.

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