Abstract
Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus (T2DM). They are therefore recommended to follow a healthy diet and be physically active in order to reduce that risk. However, achieving and maintaining these behaviours in the postpartum period is challenging. This study sought to explore women's views on suggested practical approaches to achieve and maintain a healthy diet and physical activity to reduce T2DM risk. Semi-structured interviews with 20 participants in Cambridgeshire, UK were conducted at three to 48 months after GDM. The participants' current diet and physical activity, intentions for any changes, and views on potential interventions to help manage T2DM risk through these behaviours were discussed. Framework analysis was used to analyse the transcripts. The interview schedule, suggested interventions, and thematic framework were based on a recent systematic review. Most of the participants wanted to eat more healthily and be more active. A third of the participants considered that postpartum support for these behaviours would be transformative, a third thought it would be beneficial, and a third did not want additional support. The majority agreed that more information about the impact of diet and physical activity on diabetes risk, support to exercise with others, and advice about eating healthily, exercising with a busy schedule, monitoring progress and sustaining changes would facilitate a healthy diet and physical activity. Four other suggested interventions received mixed responses. It would be acceptable for this support to be delivered throughout pregnancy and postpartum through a range of formats. Clinicians were seen to have important roles in giving or signposting to support. Many women would appreciate more support to reduce their T2DM risk after GDM and believe that a variety of interventions to integrate changes into their daily lives would help them to sustain healthier lifestyles.
Highlights
An estimated 17.8 million pregnancies resulting in live births were affected by gestational diabetes mellitus (GDM) worldwide in 2015 [1]
Supporting a healthy diet and physical activity after gestational diabetes transcripts are available via the University of Cambridge Data Repository: https://doi.org/10. 17863/CAM.76015
A third of women with GDM are diagnosed with type 2 diabetes mellitus (T2DM) by 15 years postpartum, with recent data suggesting that the increased risk is sustained over time since GDM rather than being limited to the first few years after delivery [7]
Summary
An estimated 17.8 million pregnancies resulting in live births were affected by gestational diabetes mellitus (GDM) worldwide in 2015 [1]. Women from Asia were found to have the highest incidence rate of T2DM after GDM at 46 cases per 1,000 person-years [8] Factors such as poorer pregnancy glucose tolerance requiring treatment with insulin have been found to further increase risk of T2DM [9]. Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus (T2DM). They are recommended to follow a healthy diet and be physically active in order to reduce that risk. This study sought to explore women’s views on suggested practical approaches to achieve and maintain a healthy diet and physical activity to reduce T2DM risk
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