Diagnosis of gestational diabetes: a ‘teachable moment’

Okely, Judy; Mason, Corina; Collier, Andrew; Dunnachie, Noreen; Swanson, Vivien

doi:10.1111/dme.13803

Cited by 11 publications

(15 citation statements)

References 34 publications

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“…The diagnosis of GDM has been described as a 'teachable moment', in which a diagnosis of GDM may motivate women to make health-related behavioural changes [65]. These findings and ours are supported by studies in which nutrition counselling in pregnant women with or at risk of GDM have resulted in favourable dietary changes [66][67][68].…”

Section: Discussionsupporting

confidence: 74%

Dietary Patterns and Dietary Adaptations in Women With and Without Gestational Diabetes: Evidence From the Growing Up in New Zealand Study

2020

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Diet is a cornerstone of the management of gestational diabetes (GDM). We investigated differences in dietary patterns and dietary adaptations among pregnant women with and without GDM participating in the Growing Up in New Zealand study. Presence of GDM was determined using coded clinical data and plasma glucose results meeting the New Zealand Society for the Study of Diabetes diagnostic criteria. Women answered a food frequency questionnaire and questions regarding dietary changes and information received during pregnancy. Women with GDM had lower adherence scores than those without GDM for ‘Junk’ (mean (SD) score −0.28 (0.95) versus 0.02 (1.01) p < 0.0005) and ‘Traditional/White bread’ dietary patterns (−0.18 (0.93) versus 0.01 (1.01) p = 0.002). More women with GDM reported avoiding foods high in fat or sugar (25.3% versus 5.7%, p < 0.05) compared to women without GDM. A greater proportion of women with GDM compared with those without GDM received information from dietitians or nutritionists (27.0% versus 1.7%, p < 0.05) or obstetricians (12.6% versus 7.5%, p < 0.05). More women diagnosed before the antenatal interview received advice from dietitians or nutritionists compared with those diagnosed after (46.9% versus 6.0%, p < 0.05). Women with GDM appear to make positive changes to their diet in response to advice received from health care professionals.

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Section: Discussionsupporting

confidence: 74%

Dietary Patterns and Dietary Adaptations in Women With and Without Gestational Diabetes: Evidence From the Growing Up in New Zealand Study

2020

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“…We aimed to obtain a broad insight into lifestyle change intentions of Dutch CVD patients. In previous studies that investigated the role of risk perception, affective impact, and changed self-concept on behavior outcomes, a simple size of 218 and 59 was found to be underpowered to detect moderate or high effect sizes (McBride et al, 2017 ; Okely et al, 2019 ). This current study therefore aimed to recruit as many CVD patients as possible, and based the sample size on the expected availability and response rate of participants.…”

Section: Methodsmentioning

confidence: 99%

“…Situations that urge individuals to start living a healthier life are known as “teachable moments” (TMs) (McBride et al, 2003 ; Lawson and Flocke, 2009 ). TMs generally arise during or after significant life or health events such as hospitalization, pregnancy, or severe disease diagnosis, any of which may cause an individual to become more receptive to health behavior messages and encourage changes in health behaviors (McBride et al, 2003 , 2017 ; Cohen et al, 2011 ; Okely et al, 2019 ). According to a conceptual framework proposed by McBride et al ( 2003 ), three facilitating characteristics allow life events to serve as effective TMs in terms of instigating health behavior change.…”

Section: Introductionmentioning

confidence: 99%

The COVID-19 Crisis as a Teachable Moment for Lifestyle Change in Dutch Cardiovascular Disease Patients

et al. 2021

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Objective: When lifestyle changes are needed, life events or crises such as COVID-19 may function as “teachable moments”. This study aimed to explore whether the pandemic can provoke a teachable moment regarding lifestyle change in cardiovascular disease patients.Method: In this cross-sectional survey study, 830 cardiovascular disease patients reported their intentions to change lifestyle, instigated by the corona crisis, together with risk perception, affective impact, and changed self-concept, based on a “teachable moments” framework.Results: Between 8 and 28% of the sample reported increased intentions to optimize lifestyle behaviors, particularly related to general lifestyle (28%), physical activity (25%), and diet (21%). Multivariate regression analyses revealed that changed self-concept was associated with higher intentions to improve general lifestyle (B = 0.26; CI = 0.19–0.33), physical activity (B = 0.23; CI = 0.16–0.30), and smoking (B = 0.29; CI = 0.01–0.57). In addition, changed self-concept and affective impact were both significantly associated with higher intentions to improve diet (resp. B = 0.29; CI = 0.21–0.36 and B = 0.12; CI = 0.04–0.21) and to limit alcohol consumption (resp. B = 0.22; CI = 0.13–0.30 and B = 0.11; CI = 0.01–0.20). We did not find evidence for an important role of risk perception on behavior change intentions.Conclusion: The COVID-19 crisis evoked a potential teachable moment for lifestyle change in cardiovascular disease patients, driven by a change in a patient's self-concept and to a lesser extent by an affective impact of the COVID-19 crisis. These results suggest an important window of opportunity for healthcare professionals to utilize the pandemic to promote a healthy lifestyle to their patients.

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“…The good news, however, is that because most fetal body weight is laid down in the third trimester, nutritional adaptations at this point of pregnancy are still potentially able to improve GDM outcomes [ 12 ]. Women diagnosed with GDM may be amenable to make lifestyle alterations in order to reduce the risk of GDM-related complications [ 32 ]. This is likely to have positive benefits, as the systematic review by Mitanchez and colleagues [ 13 ] in this Special Issue reported that combined lifestyle modifications, in terms of a range of dietary adaptations and increased activity levels, lead to reduced fetal growth and neonatal fat mass in women with GDM and lower rates of preterm birth and shoulder dystocia.…”

mentioning

confidence: 99%

Nutrition for Gestational Diabetes—Progress and Potential

Petry

2020

Nutrients

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Diagnosis of gestational diabetes: a ‘teachable moment’

Abstract: Future interventions designed to increase concordance could benefit from a focus on risk perception and social support, as these factors appear to be most strongly associated with following GDM treatment recommendations.

Cited by 11 publications

References 34 publications

Dietary Patterns and Dietary Adaptations in Women With and Without Gestational Diabetes: Evidence From the Growing Up in New Zealand Study

Dietary Patterns and Dietary Adaptations in Women With and Without Gestational Diabetes: Evidence From the Growing Up in New Zealand Study

The COVID-19 Crisis as a Teachable Moment for Lifestyle Change in Dutch Cardiovascular Disease Patients

Nutrition for Gestational Diabetes—Progress and Potential

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