Women's views on lifestyle changes to reduce the risk of developing Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice.
Diabetic medicine : a journal of the British Diabetic Association
Blackwell Publishing Inc.
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Dennison, B., Ward, R., Griffin, S., & Usher-Smith, J. (2019). Women's views on lifestyle changes to reduce the risk of developing Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice.. Diabetic medicine : a journal of the British Diabetic Association, 36 (6), 702-717. https://doi.org/10.1111/dme.13926
ABSTRACT Aims: After gestational diabetes, many women exhibit behaviours that increase their risk of developing type 2 diabetes. We aimed to systematically synthesise the literature focussing on the views of women with a history of gestational diabetes on reducing their risk of developing diabetes postpartum through lifestyle and behaviour changes. Methods: We identified qualitative studies that examine the views of women with a history of gestational diabetes towards healthy eating and physical activity, type 2 diabetes risk management or their experience of a diabetes prevention programme, and conducted a thematic synthesis to develop descriptive and then analytical themes. We evaluated the quality of each study and the confidence that we had in the findings using the CASP criteria and GRADE-CERQual approach. Results: We included 21 articles after screening 23,160 citations and 129 full texts. We identified six themes of interacting influences on postpartum behaviour: role as mother and priorities; social support; demands of life; personal preferences and experiences; risk perception and information; and finances and resources (plus preferred format of interventions). These factors inhibited many women from addressing their own health while they motivated some to persevere. We also developed 20 recommendations, most with high or moderate confidence, for effective promotion of healthy lifestyles in this population. Conclusions: Many factors hinder healthy lifestyles after gestational diabetes, yet how women interpret them can motivate or prevent changes that reduce diabetes risk. As our recommendations emphasise, women’s experiences and needs should be considered when designing strategies to promote healthier lifestyles in this population.
Humans, Diabetes, Gestational, Puerperal Disorders, Diabetes Mellitus, Type 2, Disease Progression, Health Behavior, Risk Reduction Behavior, Mothers, Life Style, Perception, Pregnancy, Adult, Female, Practice Guidelines as Topic, Healthy Lifestyle
RAD is funded by a PhD studentship from the National Institute for Health Research School for Primary Care Research (NIHR SPCR). This paper presents independent research funded by the NIHR SPCR. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health. RJW is funded by an NIHR Academic Clinical Fellowship. SJG is supported by the Medical Research Council (MC_UU_12015/4). The University of Cambridge has received salary support in respect of SJG from the NHS in the East of England through the Clinical Academic Reserve. JUS is funded by a Cancer Research UK Cancer Prevention Fellowship (C55650/A21464).
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0515-10119)
Cancer Research UK (21464)
External DOI: https://doi.org/10.1111/dme.13926
This record's URL: https://www.repository.cam.ac.uk/handle/1810/289041