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妊娠期糖尿病后2型糖尿病预防实施的价值观、原则和研究重点:来自亚洲、非洲、美洲、欧洲和大洋洲的全球共识

Values, principles and research priorities for the implementation of type 2 diabetes prevention after gestational diabetes: A global consensus from Asia, Africa, Americas, Europe and Oceania.

作者信息

Lim Siew, Makama Maureen, Ioannou Elysa, Skouteris Helen, Montanaro Cynthia, Taye Melaku, Kodapally Bhagiaswari, Moran Lisa J, Reja Ahmed, O'Reilly Sharleen L, Redman Leanne M, Mathews Elezebeth, Boyle Jacqueline

机构信息

Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.

Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

Diabet Med. 2025 May;42(5):e70017. doi: 10.1111/dme.70017. Epub 2025 Feb 26.

Abstract

AIMS

The implementation of type 2 diabetes prevention after gestational diabetes (GDM) is poor despite research evidence on efficacy. This is limited by the lack of knowledge of the priorities in real-world settings from the perspectives of local clinicians and women with lived experiences, particularly those from underserved populations. We report here a global consensus on the values, principles, and research priorities for the implementation of type 2 diabetes prevention in individuals after gestational diabetes (GDM), from the perspectives of clinicians and women from Asia, Africa, Oceania, the Americas, and Europe.

METHODS

A team of health professionals and researchers from five continents formed the Cardiometabolic Health Implementation Research in Postpartum individuals (CHIRP) team. The CHIRP team undertook a priority setting process using the Modified Delphi and Nominal Group Technique. Health professionals and women with a lived experience of GDM from five continents were invited to participate. Values, principles, and research priorities were voted on by all participants.

RESULTS

A total of 100 consumers and health professionals from 11 countries across the five continents participated in the consensus process. The top-ranked values and principles were 'universal access', 'evidence-based', and 'equity-driven'. The top-ranked research priorities were 'stress and mental well-being', 'information on exercise and diet', 'lactation and breastfeeding', 'exercise after childbirth', and 'physical environment for healthy eating'.

CONCLUSIONS

Addressing mental wellbeing through strategies that are universally accessible, evidence-based, and equity-driven will increase the success of the real-world implementation and knowledge translation of type 2 diabetes prevention in women with a history of GDM in global settings.

摘要

目的

尽管有关于疗效的研究证据,但妊娠期糖尿病(GDM)后2型糖尿病预防措施的实施情况不佳。这受到以下因素的限制:从当地临床医生和有实际经验的女性(尤其是来自服务不足人群的女性)的角度来看,缺乏对现实世界中优先事项的了解。我们在此报告从亚洲、非洲、大洋洲、美洲和欧洲的临床医生和女性的角度,就妊娠期糖尿病(GDM)后个体实施2型糖尿病预防的价值观、原则和研究优先事项达成的全球共识。

方法

来自五大洲的一组卫生专业人员和研究人员组成了产后个体心脏代谢健康实施研究(CHIRP)团队。CHIRP团队采用改良德尔菲法和名义小组技术进行了确定优先事项的过程。邀请了来自五大洲的有GDM实际经验的卫生专业人员和女性参与。所有参与者对价值观、原则和研究优先事项进行了投票。

结果

来自五大洲11个国家的100名消费者和卫生专业人员参与了共识过程。排名靠前的价值观和原则是“普遍可及性”、“循证”和“公平驱动”。排名靠前的研究优先事项是“压力与心理健康”、“运动和饮食信息”、“哺乳和母乳喂养”、“产后运动”以及“健康饮食的物理环境”。

结论

通过普遍可及、循证且公平驱动的策略来解决心理健康问题,将提高在全球范围内对有GDM病史的女性实施2型糖尿病预防措施以及知识转化的成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d67/12006564/f75b78420d1e/DME-42-e70017-g001.jpg

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