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Risk Perception for Diabetes among Women with Histories of Gestational Diabetes

¹General Internal Medicine, and Obstetrics & Gynecology, University of Michigan
²Division of Metabolism, Endocrinology, and Diabetes, Internal Medicine, University of Michigan
³General Internal Medicine, University of Michigan and Veterans Affairs, Center
⁴Metabolism, Endocrinology, and Diabetes, Internal Medicine, University of Michigan
⁵Research, Kaiser Permanente, Oakland, California
⁶Endocrinology, Albert Einstein College, New York City, NY

cathkim{at}umich.edu

ABSTRACT

Objective:To examine risk perception for diabetes among women with histories of gestational diabetes mellitus (GDM)

Research Design and Methods:We surveyed 217 women with histories of GDM enrolled in a managed care plan who did not currently have diabetes. In a cross-sectional design, we assessed the associations between risk perceptions and current lifestyle behavioral practices, plans to modify behaviors, and recent lifestyle behavior changes. Multivariable models included participant characteristics as well as potential modifiers of risk perception (knowledge of diabetes risk factors, optimistic bias, perceived personal control, and beliefs in the benefits and barriers of lifestyle modification).

Results:Ninety percent of women recognized that GDM was a risk factor for future diabetes, but only 16% believed that they themselves had a high chance of developing diabetes; perceived risk increased to 39% when women were asked to estimate their risk assuming they maintained their current lifestyle. Women who consumed 3 but < 5 servings a day of fruits and vegetables reported lower odds of moderate/high risk perception (adjusted odds ratio (OR) 0.39, 95% confidence interval (CI) 0.16-0.92) than women who consumed <3 servings a day, although this association was not significant after further adjustment for income. Women who perceived themselves to be at moderate/high risk more often planned to modify their future lifestyle behaviors (adjusted OR 9.1, 95% CI 1.5-57.0).

Conclusions:Despite understanding the association between GDM and postpartum diabetes, women with histories of GDM usually do not perceive themselves to be at elevated risk.

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