Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider, and Staff Perspectives

Lucas, Hannah R.; Williams, Roxann C.; Hollar, Laura; Johnson-Javois, Bethany; Miller, Heidi B.; Stoermer, Amanda; Colditz, Graham A.; James, Aimee S.; Herrick, Cynthia

doi:10.2337/cd21-0016

Cited by 7 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Management of GDM involve lifestyle modifications related to diet, self-monitored management, and exercise, which have been found difficult to adhere to by women diagnosed with GDM [ 39 , 40 ]. Therefore, involvement of the women and their significant others in their management during pregnancy, intrapartum and postpartum is crucial to achieve adherence to the care plan to manage GDM, leading to effective pregnancy and post-partum outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…This lack of emphasis can be explained by the fact that they were clinical guidelines which focused on the clinical aspects of screening and management of GDM as opposed to non-clinical aspects, such as social, cultural or socioeconomic aspects. , with the exception of one guideline [ 20 ], the guidelines supporting the recommendations were developed mainly in high-income countries and did not consider the socio-economical challenges and cultural aspects of management of GDM, the former which are experienced in many low-incomes countries, such as Ghana [ 40 , 51 , 57 ]. Globally, the socio-economic and cultural aspects need further exploration and consideration in guidelines related to screening and management of GDM.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Screening and nursing management of gestational diabetes in Ghana: Evidence-based recommendations

Mensah¹,

Rooyen²,

Ham-Baloyi³

2023

Heliyon

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Screening and nursing management of gestational diabetes in Ghana: Evidence-based recommendations

Mensah¹,

Rooyen²,

Ham-Baloyi³

2023

Heliyon

View full text Add to dashboard Cite

“…This report focuses on barriers and facilitators to postpartum T2DM screening and prevention. Patient understanding and HCP education about GDM diagnosis, diet and exercise, self-monitoring and medications, T2DM screening and prevention are reported separately [18].…”

Section: Methodsmentioning

confidence: 99%

“…Inaction with regard to guideline adherence. Patients often acknowledged that they had not to adhered to GDM management, dietary, exercise, and T2DM screening guidelines, either because of denial or lack of appreciation for the seriousness of illness [18]. Some patients did not describe why they chose not to get screened, even while acknowledging its importance.…”

Section: Barriers: Individualmentioning

confidence: 99%

Barriers and facilitators to diabetes screening and prevention after a pregnancy complicated by gestational diabetes

et al. 2022

View full text Add to dashboard Cite

Objective Gestational diabetes mellitus (GDM) is increasing in the United States, with higher rates among minoritized racial and ethnic populations and lower income populations. GDM increases risk for type 2 diabetes (T2DM), and postpartum diabetes screening and prevention are imperative. This qualitative study examines barriers and facilitators to postpartum T2DM screening and prevention among non-privately insured individuals with a history of GDM in a state prior to Medicaid expansion. Methods Thirty-six non-privately insured women with a history of GDM completed semi-structured interviews. Four focus groups and seven interviews were conducted with 30 nurse practitioners, physicians, physician assistants, nurses and registered dietitians from Federally Qualified Health Centers in St. Louis, MO. Interviews and focus groups were audio-recorded and transcribed. Data were analyzed using an integrative thematic analysis informed by the socio-ecological model. Results Barriers and facilitators to T2DM screening and prevention occur across multiple environments (society, healthcare system, interpersonal, and individual). Societal barriers include insurance issues, unemployment, and lack of transportation, childcare, safe housing, and healthy food access, while facilitators include government sponsored programs and community organizations. Healthcare system barriers include care fragmentation, scheduling policies and time constraints while facilitators include care coordination, pregnancy support groups, and education materials. Interpersonal barriers include negative care experiences, cultural differences, communication challenges, competing priorities, and lack of a social support network, while facilitators include family and friend support and positive care experiences. Individual barriers include health complications and unhealthy food and exercise patterns, while facilitators include child wellbeing, empowered attitudes and healthy food and exercise patterns. Conclusions The socioecological model highlights the societal and systemic determinants that encompass individual and interpersonal factors affecting postpartum T2DM screening and prevention. This framework can inform multi-level interventions to increase postpartum T2DM screening and prevention in this high-risk population, including policy changes to alleviate higher-level barriers.

show abstract

“…Unfortunately, there is a lack of awareness of the role these pregnancy‐related conditions play in a woman's CVD risk assessment, both in patients and their health care providers. 16 , 17 , 18 As a result, women with past pregnancy‐related complications are often lost to follow‐up without ongoing monitoring of blood pressure (BP) or screening for type 2 diabetes (T2D). 19 , 20 , 21 This is particularly evident in young women and underserved populations such as lower socioeconomic and ethnic minority groups.…”

mentioning

confidence: 99%

Prevention of Cardiovascular Disease in Women With Pregnancy‐Related Risk Factors: A Prospective Women's Heart Clinic Study

Marschner,

Mukherjee,

Watts

et al. 2023

JAHA

View full text Add to dashboard Cite

Background Hypertensive disorders of pregnancy, gestational diabetes, and having a small‐for‐gestational‐age baby are known to substantially increase a woman's risk of cardiovascular disease. Despite this, evidence for models of care that mitigate cardiovascular disease risk in women with these pregnancy‐related conditions is lacking. Methods and Results A 6‐month prospective cohort study assessed the effectiveness of a multidisciplinary Women's Heart Clinic on blood pressure and lipid control in women aged 30 to 55 years with a past pregnancy diagnosis of hypertensive disorders of pregnancy, gestational diabetes, or a small‐for‐gestational age baby in Melbourne, Australia. The co‐primary end points were (1) blood pressure <140/90 mm Hg or <130/80 mm Hg if diabetes and (2) total cholesterol to high‐density lipoprotein cholesterol ratio <4.5. The study recruited 156 women with a mean age of 41.0±4.2 years, 3.9±2.9 years from last delivery, 68.6% White, 20.5% South/East Asian, and 80.5% university‐educated. The proportion meeting blood pressure target increased (69.2% to 80.5%, P =0.004), with no significant change in lipid targets (80.6% to 83.7%, P =0.182). Systolic blood pressure (−6.9 mm Hg [95% CI, −9.1 to −4.7], P <0.001), body mass index (−0.6 kg/m 2 [95% CI, −0.8 to −0.3], P <0.001), low‐density lipoprotein cholesterol (−4.2 mg/dL [95% CI, −8.2 to −0.2], P =0.042), and total cholesterol (−4.6 mg/dL [95% CI, −9.1 to −0.2] P =0.042) reduced. Heart‐healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%, P =0.012), decreased fast food consumption (33.8% to 11.0%, P <0.001), and increased physical activity (84.0% to 92.9%, P =0.025). Conclusions Women at high risk for cardiovascular disease due to past pregnancy‐related conditions experienced significant improvements in multiple cardiovascular risk factors after attending a Women's Heart Clinic, potentially improving long‐term cardiovascular disease outcomes. Registration URL: https://www.anzctr.org.au ; Unique identifier: ACTRN12622000646741.

show abstract

Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider, and Staff Perspectives

Cited by 7 publications

References 26 publications

Screening and nursing management of gestational diabetes in Ghana: Evidence-based recommendations

Screening and nursing management of gestational diabetes in Ghana: Evidence-based recommendations

Barriers and facilitators to diabetes screening and prevention after a pregnancy complicated by gestational diabetes

Prevention of Cardiovascular Disease in Women With Pregnancy‐Related Risk Factors: A Prospective Women's Heart Clinic Study

Contact Info

Product

Resources

About