Lipscombe Lorraine L, Banerjee Ananya Tina, McTavish Sarah, Mukerji Geetha, Lowe Julia, Ray Joel, Evans Marilyn, Feig Denice S
Women's College Research Institute, Women's College Hospital, 76 Grenville St., Toronto, ON, Canada M5G 1N8; Department of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada M5S 1A8; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St. Suite 425, Toronto, ON, Canada M5T 3M6.
Women's College Research Institute, Women's College Hospital, 76 Grenville St., Toronto, ON, Canada M5G 1N8.
Diabetes Res Clin Pract. 2014 Oct;106(1):57-66. doi: 10.1016/j.diabres.2014.07.019. Epub 2014 Jul 26.
Women with gestational diabetes mellitus (GDM) have a high risk of future diabetes, which can be prevented with lifestyle modification. Prior diabetes prevention programmes in this population have been limited by lack of adherence. The aim of this study is to evaluate readiness for behaviour change at different time points after GDM diagnosis and identify barriers and facilitators, to inform a lifestyle modification programme specifically designed for this group. The objective of this paper is to present the rationale and methodological design of this study.
The ongoing prospective cohort study has recruited a multi-ethnic cohort of 1353 women with GDM from 7 Ontario, Canada hospitals during their pregnancy. A questionnaire was developed to evaluate stage of readiness for behaviour change, and sociodemographic, psychosocial, and clinical predictors of healthy diet and physical activity. Thus far, 960 women (71%) have completed a baseline survey prior to delivery. Prospective postpartum follow-up is ongoing. We are surveying women at 2 time-points after delivery: 3-12 months postpartum, and 13-24 months postpartum. Survey data will be linked to health care administrative databases for long-term follow-up for diabetes. Qualitative interviews were conducted in a subset of women to gain a deeper understanding of barriers and facilitators to lifestyle change.
Our study is a fundamental first step in effectively addressing diabetes prevention in women with GDM. Our findings will aid in the design of a diabetes prevention intervention specifically targeted to women with recent GDM, which can then be evaluated in a clinical trial.
妊娠期糖尿病（GDM）女性未来患糖尿病的风险较高，通过生活方式改变可预防。此前该人群的糖尿病预防项目因依从性不足而受限。本研究旨在评估GDM诊断后不同时间点行为改变的准备情况，识别障碍因素和促进因素，为专门针对该群体设计的生活方式改变项目提供依据。本文的目的是介绍本研究的基本原理和方法设计。
正在进行的前瞻性队列研究招募了来自加拿大安大略省7家医院的1353名患有GDM的多民族孕妇队列。设计了一份问卷，以评估行为改变准备阶段，以及健康饮食和体育活动的社会人口统计学、心理社会和临床预测因素。到目前为止，960名女性（71%）在分娩前完成了基线调查。产后前瞻性随访正在进行。我们在产后两个时间点对女性进行调查：产后3 - 12个月，以及产后13 - 24个月。调查数据将与医疗保健管理数据库相链接，以便对糖尿病进行长期随访。对一部分女性进行了定性访谈，以更深入地了解生活方式改变的障碍因素和促进因素。
我们的研究是有效解决GDM女性糖尿病预防问题的重要第一步。我们的研究结果将有助于设计专门针对近期患有GDM的女性的糖尿病预防干预措施，然后可在临床试验中进行评估。
