Dataset Information

Multidisciplinary Group Education for Gestational Diabetes Mellitus: A Prospective Observational Cohort Study.

ABSTRACT: The value of diabetes education, focusing on lifestyle measures, in women with gestational diabetes mellitus (GDM) is acknowledged, but requires intensive education and input of resources if done on an individual basis. Group education could be a valuable alternative to individual education. This study aims to investigate the impact of multidisciplinary group education on women's knowledge about GDM, education, treatment satisfaction, and emotional status. Two hundred women with GDM were enrolled in a prospective observational study. Dutch speaking women were offered group education at their first visit after GDM diagnosis. Non-Dutch speaking women or women for whom group education was not possible received individual education. Individual follow-up with a dietitian was planned within two weeks for all women. Women receiving individual education (n = 100) were more often from an ethnic minority background compared to women in group education (n = 100) (32.0% (n = 31) vs. 15.3% (n = 15), p = 0.01). Knowledge about GDM significantly improved after education, with few differences between the two education settings. Both patients in group and individual education were equally satisfied with the content and duration of the initial and follow-up education. Of all group participants, 91.8% (n = 90) were satisfied with group size (on average three participants) and 76.5% (n = 75) found that group education fulfilled their expectations. In conclusion, women diagnosed with GDM were overall satisfied with the education session's content leading to a better understanding of their condition, independent of the education setting. Group education is a valuable alternative to better manage the increasing workload and is perceived as an added value by GDM patients.

SUBMITTER: Minschart C

PROVIDER: S-EPMC7073549 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Multidisciplinary Group Education for Gestational Diabetes Mellitus: A Prospective Observational Cohort Study.

Minschart Caro C Amuli Kelly K Delameillieure Anouk A Calewaert Peggy P Mathieu Chantal C Benhalima Katrien K

Journal of clinical medicine 20200213 2

The value of diabetes education, focusing on lifestyle measures, in women with gestational diabetes mellitus (GDM) is acknowledged, but requires intensive education and input of resources if done on an individual basis. Group education could be a valuable alternative to individual education. This study aims to investigate the impact of multidisciplinary group education on women's knowledge about GDM, education, treatment satisfaction, and emotional status. Two hundred women with GDM were enrolle ...[more]

PMID: 32069855

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Project description:Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.We included 21,411 singleton pregnancies in the Nurses' Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal fat; and a vegetable LCD score on the basis of intakes of carbohydrate, vegetable protein, and vegetable fat. A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models.We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons of highest with lowest quartiles were 1.27 (1.06, 1.51) for the overall LCD score (P-trend = 0.03), 1.36 (1.13, 1.64) for the animal LCD score (P-trend = 0.003), and 0.84 (0.69, 1.03) for the vegetable LCD score (P-trend = 0.08). Associations between LCD scores and GDM risk were not significantly modified by age, parity, family history of diabetes, physical activity, or overweight status.A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high protein and fat from vegetable food sources is not associated with the risk. Women of reproductive age who follow a low-carbohydrate dietary pattern may consider consuming vegetable rather than animal sources of protein and fat to minimize their risk of GDM.

Project description:ObjectiveTo quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes.DesignProspective cohort study.SettingNurses' Health Study II, United States.Participants20,136 singleton live births in 14,437 women without chronic disease.Main outcome measureSelf reported incident gestational diabetes diagnosed by a physician, validated by medical records in a previous study.ResultsIncident first time gestational diabetes was reported in 823 pregnancies. Each lifestyle factor measured was independently and significantly associated with risk of gestational diabetes. The combination of three low risk factors (non-smoker, ≥ 150 minutes a week of moderate to vigorous physical activity, and healthy eating (top two fifths of Alternate Healthy Eating Index-2010 adherence score)) was associated with a 41% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.59, 95% confidence interval 0.48 to 0.71). Addition of body mass index (BMI) <25 before pregnancy (giving a combination of four low risk factors) was associated with a 52% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.48, 0.38 to 0.61). Compared with pregnancies in women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of gestational diabetes (relative risk 0.17, 0.12 to 0.25). The population attributable risk percentage of the four risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar population attributable risk percentage (49.2%) was observed when the distributions of the four low risk factors from the US National Health and Nutrition Examination Survey (2007-10) data were applied to the calculation.ConclusionsAdherence to a low risk lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective strategy for the prevention of gestational diabetes.

Project description:Background: The association of bisphenol A (BPA) and gestational diabetes mellitus (GDM) has been investigated in only a small number of studies, and research on the associations between BPA substitutes and GDM is scarce. Objective: We aimed to investigate the associations of four bisphenols [bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF), and bisphenol AF (BPAF)] levels in urine sample with the risk of gestational diabetes mellitus (GDM) and plasma glucose levels. Methods: A total of 1,841 pregnant women from a cohort study were recruited at their first prenatal examination between 2013 and 2015 in Wuhan, China. Concentrations of four bisphenols (BPA, BPS, BPF, BPAF) were measured in first-trimester urine samples using Ultra-high performance liquid chromatography system coupled to a Triple Quadrupole mass spectrometer (UHPLC-TQMS). An oral glucose tolerance test (OGTT) was performed at 24-28 gestational weeks and GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. We used multivariable logistic regression models to examine the associations of urinary bisphenols with the risk of GDM, and multiple linear regression models to determine the associations between bisphenols exposure and plasma glucose levels. Results: Urinary BPAF was associated with increased odds of GDM among women with normal pre-pregnancy BMI [adjusted odds ratio (aOR) = 1.70 (95% CI: 1.08, 2.67) for the highest group compared to the lowest group], and the association remained significant after additional adjustment for other bisphenols [aOR = 1.68 (95% CI: 1.03, 2.72)]. No significant associations were observed for other bisphenols and GDM. Consistent with the result of GDM, women in the highest BPAF category had a mean of 0.05 mmol/L (95% CI: 0.01, 0.09) higher fasting plasma glucose (FPG) levels than women in the lowest category. For BPA and plasma glucose, non-linear associations were observed between urinary BPA and FPG and the sum of the PG z-score among women who were overweight (p for non-linear association < 0.05). We also found that the per-unit increase in natural log transformed specific gravity adjusted BPS [ln (SG-adj BPS)] was associated with a 0.03 mmol/L (95% CI: 0.01, 0.04) increase in FPG levels and the associations might be modified by fetal sex (p for interaction < 0.05). Among women with female fetus, a per-unit increase in ln (SG-adj BPS) was associated with a 0.04 mmol/L (95% CI: 0.02, 0.06) increase in FPG, a 0.11 mmol/L (95% CI: 0.04, 0.17) increase in 1 h-PG and a 0.19 mmol/L (95% CI: 0.08, 0.30) increase in the sum of PG z-score. Conclusions: Our results provide evidence that BPAF and BPS might be potential risk factors of GDM, which require to be studied further.

Dataset Information

Multidisciplinary Group Education for Gestational Diabetes Mellitus: A Prospective Observational Cohort Study.

Publications

Multidisciplinary Group Education for Gestational Diabetes Mellitus: A Prospective Observational Cohort Study.

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