Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
Healthcare (Basel). 2014 Nov 21;2(4):468-91. doi: 10.3390/healthcare2040468.
Type 2 Diabetes Mellitus (T2DM) and Gestational Diabetes (GDM) are important and escalating problems worldwide. GDM increases the risk of complications in pregnancy and birth, as well as a 1 in 2 chance of developing T2DM later in life. The burden of GDM extends to offspring, who have an increased risk of obesity and diabetes-further perpetuating the cycle of diabetes within families. Clinical trial evidence demonstrates T2DM incidence reduced by up to 50% for women with GDM with nutrition and physical activity changes and the economic modeling suggests cost effectiveness. The key diet-related changes to reduce T2DM risk are reviewed, in addition to breastfeeding. The difficulties associated with the delivery of dietary and lifestyle behaviour change to women after GDM are discussed and focus on: complex healthcare system interactions needed for care delivery; women finding postpartum self-care challenging; and low levels of awareness being present across the board. In addition, studies currently underway to improve care provision in this important area will be examined.
2 型糖尿病(T2DM)和妊娠期糖尿病(GDM)是全球范围内重要且不断加剧的问题。GDM 增加了妊娠和分娩并发症的风险,以及一生中发展为 T2DM 的几率为 1/2。GDM 的负担延伸到后代,他们肥胖和糖尿病的风险增加——进一步在家庭中延续了糖尿病的循环。临床试验证据表明,通过改变营养和身体活动,GDM 女性的 T2DM 发病率降低了多达 50%,并且经济模型表明具有成本效益。除了母乳喂养外,还回顾了降低 T2DM 风险的关键饮食相关变化。讨论了与 GDM 后向女性提供饮食和生活方式行为改变相关的困难,并侧重于:提供护理所需的复杂医疗保健系统相互作用;女性发现产后自我保健具有挑战性;以及普遍存在的低意识水平。此外,还将研究目前正在进行的改善这一重要领域护理服务的研究。