Risk Perception for Diabetes Among Women With Histories of Gestational Diabetes Mellitus

  1. Catherine Kim, MD, MPH1,
  2. Laura N. McEwen, PHD2,
  3. John D. Piette, PHD3,
  4. Jennifer Goewey, MHA2,
  5. Assiamira Ferrara, MD, PHD4 and
  6. Elizabeth A. Walker, PHD, RN5
  1. 1Division of General Medicine, Departments of Internal Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
  2. 2Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
  3. 3Division of General Medicine, Department of Medicine, University of Michigan and the Department of Veterans Affairs, Center for Practice Management and Outcomes Research, Ann Arbor, Michigan
  4. 4Division of Research, Kaiser Permanente Northern California, Oakland, California
  5. 5Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, New York, New York
  1. Address correspondence and reprint requests to Catherine Kim, MD, MPH, 300 NIB, Room 7C13, Box 0429, Ann Arbor, MI 48109. E-mail: cathkim{at}umich.edu


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 who were enrolled in a managed-care plan and 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 three or more but less than five servings a day of fruits and vegetables reported lower odds of moderate/high risk perception (adjusted odds ratio [OR] 0.39 [95% CI 0.16–0.92]) than women who consumed less than three 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 (9.1 [0.16–0.92]).

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.


  • Published ahead of print at http://care.diabetesjournals.org on 15 June 2007. DOI: 10.2337/dc07-0618.

    Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc07-0618.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted June 6, 2007.
    • Received March 28, 2007.
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  1. Diabetes Care vol. 30 no. 9 2281-2286
  1. Online-Only Appendix
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