AMANDA BJÖRK JAVANSHIRI: Gestational Diabetes and Lifestyle Behavior in Primary Care

Project description

Background

Women with previous GDM have a tenfold increased risk of developing T2DM and nearly 50% of these women are diagnosed later in life. Thus, there is a window of opportunity to prevent T2DM as well as to avoid or delay diabetes complications through systematic follow-up and preventive measures. Something that primary care should take responsibility for, according to Swedish national guidelines. Likewise primary care manages most people with hypertension in Sweden, another group susceptible to CVD. However, the resources are limited to intervene with the lifestyle changes needed for primary and secondary prevention. Previous research as well as guidelines emphasize the importance of follow-up and screening of these high-risk groups. Nevertheless, there are no Swedish studies on how this is complied with or if e-health could be a useful and efficient tool to assist health personnel in their health promoting work.

Aim

To illustrate the care of women with previous GDM from different perspectives, and to study disease prevention with lifestyle interventions in primary care.

Method

• I.Retrospective cohort study that investigated whether women with previous GDM were followed-up in primary care according to national guidelines. Reported by descriptive statistics.
• II.Qualitative interview study with the aim to explore the experiences from women with previous GDM regarding the diagnosis, care and treatment with lifestyle interventions. Qualitative content analysis is used.
• III.Randomized controlled multicenter study, PUSHME (Primary care USage of Health promoting Messages), with a partial study aiming to evaluate the effect of lifestyle advice via SMS on self-rated health and quality of life (EQ5D-5L) compared to usual care in patients with hypertension. Analyzed using comparative statistics and regression analysis.
• IV.Randomized controlled intervention study investigating if SMS with lifestyle advice can improve unhealthy lifestyles among women with previous GDM. Analyzed using comparative statistics and regression analysis.

Relevance

It is of importance to study how women with previous GDM and patients with hypertension are cared for in primary care and to develop new methods to improve lifestyle as well as risk profile in these high-risk populations. Ultimately, improved care could reduce the risk of developing T2DM and CVD, which would be beneficial not only for these patients’ health and long-term outcomes but also from a health economic perspective.