Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.
NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia.
Nutrients. 2023 Jan 17;15(3):487. doi: 10.3390/nu15030487.
Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation.
An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions.
A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with "low-carbohydrate" diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were "lack of time" (71.4%) and "childcare" commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%).
Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation.
妊娠糖尿病（GDM）影响约六分之一的妊娠，对母婴健康造成重大负担。生活方式干预是管理血糖水平（BGL）和预防未来心血管代谢并发症的一线治疗方法。然而，患有 GDM 的女性在生活方式干预方面面临着相当大的障碍；因此，本研究旨在确定患有 GDM 的女性如何管理其病情，并确定参与生活方式干预的主要支持和障碍。
对澳大利亚有 GDM 病史的女性进行了在线横断面调查。问题包括参与者的人口统计学资料、管理 BGL 的策略、体育活动和饮食习惯以及生活方式干预的障碍和支持。
共有 665 人同意并回复了广告，其中 564 人符合条件，并对调查问题提供了部分或完整的回复。大多数受访者年龄在 35 岁至 39 岁之间（35.5%），未怀孕（75.4%），兼职工作（26.7%），受过大学教育（58.0%），且只有一个孩子（40.1%）。大多数受访者通过饮食管理 BGL（88.3%），其中“低碳水化合物”饮食最受欢迎（72.3%），46.2%的受访者正在接受胰岛素治疗。只有 42.2%和 19.8%的受访者分别报告符合有氧运动和强化锻炼的建议。有一个孩子或目前怀孕并期待第一个孩子的女性比有两个或更多孩子的女性更有可能（95%CI，1.02，2.25）符合有氧运动建议。参与生活方式干预的最常见障碍是“缺乏时间”（71.4%）和“育儿”承诺（57.7%）。产后 6 至 12 个月（59.0%）进行的生活方式干预，涉及锻炼计划（82.6%），并进行一对一干预最受欢迎（64.9%）。
大多数女性报告通过生活方式策略来管理 GDM。报告的最常见策略包括目前不符合临床实践指南的方法，例如减少碳水化合物的摄入。此外，尽管愿意参与生活方式干预，但受访者报告存在重大障碍，包括缺乏时间和育儿承诺，而提到的支持措施包括在线形式。针对有 GDM 病史的女性的生活方式干预应根据个人情况进行设计，并考虑到参与的现有障碍和支持。
Zotero 插件