Assessment of readiness to prevent type 2 diabetes in a population of rural women with a history of gestational diabetes

Abstract

Introduction: Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus. Given the rapidly increasing prevalence of diabetes globally, there is an urgent need to develop preventative strategies and to identify high risk populations who would most benefit from diabetes prevention.

Objective: To investigate readiness to prevent diabetes in a cohort of rural women with a recent history of GDM.

Setting: Women with a recent history of GDM in regional and rural Victoria, Australia.

Methods: All women who had attended a regional diabetes centre in the past 14 months (June 2004 to July 2005) for treatment of GDM, were surveyed by mail. Variables measured included readiness to engage in physical activity and weight management as measured by the transtheoretical model of behaviour change, and perception of diabetes risk.

Results: Of the 53 women who completed the survey (mean age 32.5 years), 58% were classified as in pre-action for activity and 75% in pre-action for weight loss. Highest prevalence of pre-action for both activity and weight loss was among women with more than two children, high BMI, and those not engaged in paid work. Eighty-five percent of women in pre-action for activity were also in pre-action for weight loss. Neither physical activity nor weight loss behaviour was influenced by baby age. Nearly all respondents agreed that regular exercise, healthy diet and healthy weight, were very important to prevent diabetes, and the majority of respondents were optimistic about preventing type 2 diabetes mellitus. However, just under half (43%) of the total cohort were not engaged in any diabetes risk reduction behaviour.

Conclusion: The prevalence of physical activity and weight loss behaviour was found to be low in a rural population of women with a history of GDM, despite a high awareness of diabetes prevention strategies. Future planning for diabetes prevention will need to target this knowledge-behaviour gap. In addition to child care services and partner support, programs designed to target ambivalence to behaviour change, including structured stage-matched interventions, may have success in this vulnerable and high risk group.