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

Abstract

We conducted a qualitative study to explore the risk perceptions, health beliefs and behaviours of women with a previous history of gestational diabetes mellitus (GDM). Women aged between 18 to 40 years (at the time of pregnancy) with a previous history of GDM, registered at The Royal Liverpool University Hospital, United Kingdom, participated in individual, semi‐structured, face‐to‐face interviews. Qualitative data from seven participants were collected until data saturation and were analysed by thematic analysis. Participants had a low‐risk perception of the future risk of developing diabetes. Some believed that their risk was the same as that of any other woman without a history of GDM, and some other participants were not aware of the risk at all and perceived GDM as a temporary health condition with no long‐term risks. Participants showed some understanding of a healthy lifestyle in general. However, most of the information was self‐acquired by participants and not linked to the future risk of developing diabetes. The findings of this research also indicated a contrast between the high perception of the immediate risks of complications during the pregnancy and low long‐term risk of developing diabetes after pregnancy associated with GDM. Participants received healthy lifestyle advice during their pregnancy, but none of them reported involvement in any postnatal health education, intervention or counselling as recommended by 2008 and 2014 NICE guidelines. The low‐risk perception impedes positive health behaviour required to overcome the barriers against a healthy lifestyle. This was a small research project but the findings warrant scope for more research in this field. A larger study might promote the development of a well‐structured, long‐term follow‐up health intervention programme, incorporating a reminder system for annual diabetes screenings to improve the risk perception and reduce the risk for the development of type 2 diabetes in this population. Copyright © 2018 John Wiley & Sons.

Barriers to and enablers of type 2 diabetes screening among women with prior gestational diabetes: A systematic review update and qualitative synthesis applying the Theoretical Domains Framework

“…Where future type 2 diabetes risk was communicated accurately, many women recalled the advice and acted: ‘I was told by my doctor that I no longer have gestational diabetes, so I was quite happy…I do remember that I need to stay healthy…because I don't want to develop type 2 diabetes’ 65 . Where HCPs did not communicate, or underemphasised personal type 2 diabetes risk, ‘women's perceptions about the significance of gestational diabetes follow‐up in the postnatal period were challenged’ 52 …”

Prevalence of Metabolic Syndrome in Women After Maternal Complications of Pregnancy: An Observational Cohort Analysis

“…Even after being informed of their increased risk, most women attending the Maternal Health Clinic in Canada continued to underestimate their risk ( 10 ). Furthermore, women with gestational diabetes also underestimate their risk of developing type 2 diabetes ( 47 ), generally tend to not adopt healthy lifestyles postpartum ( 48 ), and report a number of barriers to making healthy lifestyle changes ( 49 ). It is therefore vital to provide structured follow up care for these patients to encourage positive lifestyle modifications as soon as possible.…”

Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

“…Previous studies have shown that T2DM can be prevented in this population, by adopting changes in lifestyle and/or by medication ( 6 , 7 ). However, adherence to a healthy lifestyle is often low in early postpartum due to barriers such as lack of time, need for childcare and lack of social support ( 8 ). Besides lifestyle changes, lactation has also shown to reduce the risk to develop T2DM ( 9 ).…”