Poster Presentation International Association of the Diabetes and Pregnancy Study Groups 2022 - Hosted by ADIPS

Perception of Diabetes Risk Among Australian Women With Gestational Diabetes (#115)

Simone L Marschner 1 , Clara K Chow 1 2 , Aravinda Thiagalingam 1 2 , David Simmons 3 4 , Mark Mclean 5 6 7 , Dharmintra Pasupathy 8 , Ben J Smith 1 9 , Vicki Flood 1 9 , Suja Padmanabhan 8 , Sarah J Melov 8 10 , N Wah Cheung 1 6
  1. Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia
  2. Department of Cardiology, Westmead Hospital, Westmead, NSW, Australia
  3. Macarthur Diabetes Service, Campbelltown Hospital, Campbelltown, NSW, Australia
  4. Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
  5. Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
  6. Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, Australia
  7. School of Medicine, University of Western Sydney, Campbelltown, NSW, Australia
  8. Discipline of Obstetrics, Gynaecology & Neonatology, Westmead Clinical School, The University of Sydney, Westmead, NSW, NSW, Australia
  9. Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  10. Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, NSW, Australia

 

INTRODUCTION: The risk of type 2 diabetes is 6-10 times1-3 higher for women with a history of gestational diabetes (GDM), yet women are not adhering to healthy lifestyles nor having routine diabetes screening tests.4

AIM: To examine whether women with GDM perceive their risk of diabetes to be high and the factors associated with this perception.

METHODS: The SMARTMUMS2 trial5 recruited women with GDM antenatally who were then randomised post-partum to usual care or a patient-centred diabetes prevention program via customised mobile phone text messages, facilitated using an activity monitor. Baseline data from this trial were analysed to estimate the proportion who perceived the risk of future diabetes diagnosis as low (very low, low and not low or high) or high (very high and high). This risk perception was based on the question: ‘What do you think your risk of getting diabetes in the future is?’ Logistic regression with lasso selection of the final model was used to explore the association of perceived risk (high or low) with patient characteristics such as ethnicity, obesity (body mass index ≥ 30), eating habits, physical activity levels, family history of diabetes, smoking status, and medical conditions such as depression, polycystic ovarian syndrome, hyperlipidaemia or hypertension.

RESULTS: SMARTMUMS2 recruited 177 women with mean age 32.2 (±4.6) years from three teaching hospitals in Western Sydney. Most (53.0%, CI: 45.6, 60.4) women felt that they had low risk of developing diabetes. The final model for whether women perceived themselves at high risk for future diabetes included: family history of diabetes (OR=4.0, CI: 2.1, 8.1), history of polycystic ovarian syndrome (OR=2.7, CI:1.1, 7.5) and self-reported depression diagnosis (OR=7.9, CI: 2.3, 37.7). Ethnic origin was significant at the univariate level, with those identifying as Australian or New Zealander more likely to perceive their risk as high (61.0%, CI: 53.9, 68.1) compared to those identifying as other ethnic origins (43.0%, CI: 35.8, 50.2). However, because of its strong association with self-reported depression it was not retained in the final model.

CONCLUSION: Despite diabetes education and participation in a trial aimed at reducing diabetes risk, over half the women with GDM did not perceive themselves to be at risk of future diabetes, especially those who identify as non-Australian origin and those without other medical history. Better targeting and communication of the message of substantial heightened diabetes risk for all women after a gestational diagnosis is needed.