Views of mothers and healthcare professionals on lifestyle interventions to reduce risk of type 2 diabetes after gestational diabetes: An online survey

Women diagnosed with gestational diabetes (GDM) have an increased risk of subsequently developing Type 2 Diabetes Mellitus (T2DM); this risk is further increased in the presence of an elevated BMI. Lifestyle interventions in the postpartum period have shown potential to reduce the progression to T2DM, however postpartum mothers are hard to engage in lifestyle interventions. We have therefore undertaken a survey amongst healthcare professionals and mothers diagnosed with GDM, as part of the formative evaluation for the development of a lifestyle intervention in this population. Two online surveys were performed: One amongst GPs, midwives, obstetricians and diabetologists (n = 46) and a second, with postnatal GDM mothers (n = 83). The survey contained questions concerning attitude to weight management, exercise and diet; the ideal time to engage postpartum mothers; barriers and facilitators to lifestyle change and questions about intervention content and preferred modes of delivery. Likert questions were measured on a 5-point scale: 1 strongly disagree to 5 strongly agree). Results were analysed by SPSS 23.0, using ANOVA and non-parametric tests. Mothers had a positive attitude to weight management, healthy eating and exercise. (3.86 ± 0.35; 3.58 ± 0.58; 3.52 ± 0.57); younger mothers were more positive about exercise than older mothers (P = 0.043). Barriers identified were the difficulty of balancing your own health needs with the demands of a baby (36% agreed, Md 3), tiredness (64% agreed, Md 4) and the need for childcare in order to exercise (64% agreed, Md 4). Healthcare professional indicated that women are not aware of the T2DM risk after a GDM diagnosis and 38% found the subject of weight difficult to discuss. There was a wide range of responses from mothers and healthcare practitioners about the best time to engage mothers indicating that the appropriate time may vary from individual to individual. The preferred intervention design was group sessions, in the community. Technology based interventions, delivered via mobile or internet, were preferred by 22% of the mothers. Both healthcare practitioners and mothers agreed the intervention should contain dietary advice, exercise sessions and weigh-ins. Mothers were less in favour of cooking sessions than healthcare practitioners (P=0.043). Walking was the most popular form of exercise to include. Healthcare practitioners and post-GDM mothers are supportive of a lifestyle intervention in the community. The intervention should be flexible, allow women to engage at a time that is appropriate for them and needs to consider childcare constraints