Mukerji G, Kainth S, Pendrith C, Lowe J, Feig D S, Banerjee A T, Wu W, Lipscombe L L
Women's College Hospital, Toronto.
Department of Medicine, University of Toronto, Toronto.
Diabet Med. 2016 Oct;33(10):1437-44. doi: 10.1111/dme.13009. Epub 2015 Dec 12.
To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception.
Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question.
Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI < 25 kg/m(2) , absent previous gestational diabetes history, absent diabetes family history and absent insulin use were appropriately associated with low diabetes risk perception. However, compared with Caucasian ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22).
Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk.
确定患有妊娠期糖尿病的女性中低估自身糖尿病风险的比例，并识别与糖尿病风险认知较低相关的因素。
研究对象包括2009年至2012年间加拿大安大略省七家糖尿病诊所的成年妊娠期糖尿病女性。通过病历审查和一项包含糖尿病风险认知问题的调查收集数据。
在902名患有妊娠期糖尿病的女性中，614名（应答率68%）参与了研究，其中89%正确回答了妊娠期糖尿病会增加患糖尿病的风险。然而，47.1%的女性认为自己在未来10年内患糖尿病的风险较低。多变量分析显示，体重指数（BMI）<25kg/m²、既往无妊娠期糖尿病史、无糖尿病家族史以及未使用胰岛素与较低的糖尿病风险认知相关。但是，与白种人相比，高危种族（原住民、拉丁裔、西印度人、南亚人、中东人、菲律宾人、黑人、太平洋岛民）[比值比（OR）2.07；95%置信区间（CI）1.30 - 3.31]以及东亚和东南亚种族（OR 2.01；1.10 - 3.67）与较低的糖尿病风险认知相关。在进一步调整移民因素后，只有高危种族仍然是糖尿病风险认知较低的预测因素（OR 1.86；1.09 - 3.19），而东亚和东南亚种族则不再是（OR 1.67；0.86 - 3.22）。
尽管大多数女性认识到妊娠期糖尿病是糖尿病的一个风险因素，但几乎一半的女性尽管接受了产前护理，仍低估了自身患糖尿病的高风险。此外，即使在调整移民因素后，高危种族的女性仍更有可能低估其风险。针对这些群体制定的干预措施对于提高糖尿病风险认知是必要的。
