Diabetes Risk Reduction Practices Low for Women With Gestational Diabetes
For women in rural populations, access to education and care is limited, causing disparities in diabetes care.
Despite the awareness of diabetes prevention, the prevalence of physical activity and weight loss behavior was low for women with a history of gestational diabetes in rural populations, according to findings published in Rural and Remote Health. Investigators said that programs designed to target behavior changes, such as structured interventions, could help improve the prevalence in vulnerable and high-risk groups.1
For women in rural populations, access to education and care is limited, causing disparities in diabetes care. | Image Credit: Subbotina Anna - stock.adobe.com
“This study is the first to investigate readiness to change among Australian rural women with a history of GDM, which increases their risk of developing T2DM,” the study authors said.1 “The findings indicate a clear need to promote physical activity and weight loss in the postnatal period to this high-risk group.”
According to an article in BJOG: An International Journal of Obstetrics and Gynaecology, the rate of pregestational and gestational diabetes has been increasing in the US, occurring in 1% and 8% of all pregnant women in 2020, respectively. Pregnant women in rural areas also face unique challenges, and 80% of maternal care deserts occur in rural counties, so access is limited. Although the frequency of diabetes and gestational diabetes increased in both rural and urban areas, there are significant rural-urban disparities that exist, especially for those who are Hispanic and those who live in the South.2
In the current study, investigators used a cohort of women with a history of gestational diabetes in rural areas. The pilot study was aimed at determining diabetes risk reduction behavior when achieving a healthy weight and being physically active. They included patients from a large regional hospital in northern Victoria, Australia, who attended the diabetes center from July 2004 to July 2005 for the management of gestational diabetes. In total, 53 women were included and completed the survey. Approximately 68% of women had 2 or more children, and 49% had a child less than 6 months old. Based on self-reported height and weight, 24% were overweight and 42% were obese.1
Investigators found that 58% of patients were classified as preaction for physical activity, and of these, 3% were at precontemplation, 25% were at contemplation, and 52% were at the preparatory state. There were also 42% who met the active stage. For those in the preaction state, patients were slightly younger, with a mean age of 31.5 years, than patients in action, with a mean age of 34.1 years. Preaction for activity also had the highest prevalence in women with a body mass index above 25 kg/m2, women in preaction for weight loss, and women who are not paid for work. The study authors stated that physical activity was not influenced by the baby’s age, but women with more than 2 children were in preaction for activity (61%) or preaction for weight loss (80%).1
There were 17% of women who responded that their weight was healthy. For those who felt they needed to lose weight, 41% were at contemplation, 34% were at preparation for weight loss, 15% were at action, and 10% were at maintenance of weight loss. Investigators stated that women engaging in diabetes risk reduction were either of healthy weight or actively losing weight while being active. Approximately 43% were at preaction for activity and weight loss and were not engaging in diabetes risk reduction, according to the study authors.1
“Overall, these results represent the views of this group of rural women with a history of GDM [gestational diabetes],” the study authors said.1 “Encouraging individuals at high risk of chronic disease to change lifestyle behaviours [is] often difficult and, therefore, understanding what factors these women believe to be important in diabetes prevention may help in the development of more effective and efficient interventions.”
READ MORE: Women's Health Resource Center
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