Perceived and Actual Cardio-metabolic Risk among Women with a Recent History of Gestational Diabetes

Background: Women with previous gestational diabetes (pGDM) are at risk for cardio-metabolic disease. However, there is no consensus regarding risk-counseling or dietary management for pGDM women. This study assessed perceived and actual cardio-metabolic risk of Atlanta-area pGDM women within three years of diagnosis. Methods: Women with pGDM (n=16) were assessed for perceived risk of diabetes (Risk Perception Survey for Developing Diabetes, including Personal Control, Worry, and Optimistic Bias subscales), knowledge of dietary guidelines (adapted 2010 US Dietary Guidelines knowledge questionnaire) and cardio-metabolic risk (hemoglobin A1C, blood pressure, lipids and anthropometric factors). Data were analyzed with descriptive and correlational statistics. Results: Participants mean age was 37.5 (5.3) years and BMI was 27.6 (6.0). They were 40% Black, 40% White, 27% Hispanic and 1.8 (1.1) years since diagnosis. Most (75%) reported receiving no post-partum lifestyle counseling and 58% believed they had no or slight chance in developing type 2 diabetes mellitus within the next ten years. Knowledge of diabetes risk factors (test score=57.8% (19.2) and dietary guidelines (mean test score=33.6% (18.6)) was low. Most women did not have metabolic syndrome (80%); however, 58% were overweight or obese and 50% were prediabetic. Greater worry of diabetes risk was associated with higher hemoglobin A1C levels (r=0.75, p=.005). Conclusions: This preliminary study reveals that women with pGDM in metropolitan Atlanta do not perceive themselves at risk for cardio-metabolic disease, despite multiple risk factors. Addressing risk reduction and health promotion strategies among this high-risk group of women is indicated.