Abstract
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.
Highlights
Gestational diabetes (GDM), defined as glucose intolerance that begins or is first recognized during pregnancy [1], is a growing health issue around the world
The overall response rate could not be calculated as there were no data available on how many people saw the online advertisements; n = 4160 invitations were sent through mail and email
Given the barriers to weight loss that women in this study have identified, factors relating to lack of time and family responsibilities, as well as a lack of motivation to change, a two-day-a-week diet may be an achievable weight loss strategy for some women with previous GDM
Summary
Gestational diabetes (GDM), defined as glucose intolerance that begins or is first recognized during pregnancy [1], is a growing health issue around the world. In 2016–2017, 40,000 (15%) pregnancies in Australia were affected by GDM [2]. GDM affected 16% of live births in 2019, with 20.4 million babies being born from a GDM pregnancy [3]. GDM typically resolves shortly after birth, the risk of developing type 2 diabetes (T2DM) is nearly 10 times higher for women with a history of GDM compared to women who did not have GDM in pregnancy [4]. Being in an overweight or obese weight category further increases the risk of developing T2DM after GDM [5,6].
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