New UK qualitative study may inform future intervention development to reduce long-term impact of gestational diabetes.
By Dr Elizabeth Holmes-Truscott
The potential long-term impact of gestational diabetes mellitus (GDM) on women’s health was highlighted across news outlets last month following the publication of a retrospective cohort study  of more than 9,000 women with GDM in the UK. Results suggested that women with GDM were 20 times more likely to go on to develop type 2 diabetes (T2D) and at higher risk of hypertension and heart disease compared to a matched sample without GDM. Furthermore, following pregnancy, clinical screening rates for T2D were lower than recommended. Thus, there is a clear need for additional health professional training, resources and support for women with GDM following pregnancy to prevent or delay development of long-term chronic conditions.
To inform the development of such interventions, Eades  and colleagues (University of Stirling ) conducted a qualitative study  (N=16) to explore the existing experiences, knowledge and perceptions of women with GDM. Participants reported a good understanding of GDM and that education received at the time of diagnosis was adequate. However, a need for tailored dietary and physical activity advice was identified. Many participants questioned the accuracy and seriousness of their GDM diagnosis, and the perceived impact of the condition varied between participants. For some, GDM was of little concern, while others reported difficulties in self-management and worries about the impact of high blood glucose on their unborn child. In general, participants concern about their increased risk of developing T2D was low. While most participants were aware of their increased risk, they downplayed their own perceived risk in comparison to other women with GDM. Therefore, it is unsurprising that few of the women continued to make or maintain lifestyle changes following pregnancy. Reported barriers included competing demands associated with motherhood, a lack of prioritization of their own health, and limited aftercare following pregnancy. Furthermore, participants reported limited understanding of T2D and its causes. Participants reported potential facilitators of maintaining, or initiating, lifestyle changes following pregnancy, including further education/information accompanying clinical screening and peer support programs.
This qualitative research identifies a limited understanding among women with GDM about their long-term personal health risks and identifies the need for additional education and ongoing postnatal support in order to ensure appropriate illness perceptions and increase preventative self-care.
Eades CE, France EF, Evans JM. Postnatal experiences, knowledge and perceptions of women with gestational diabetes . Diabetic Medicine. 2018 Jan 16. 10.1111/dme.13580