title: Preventing type 2 diabetes after gestational diabetes: women's experiences and implications for diabetes prevention interventions.
abstract: OBJECTIVE
  To explore factors influencing post-natal health behaviours following the experience of gestational diabetes, and to elicit women's views about the feasibility of lifestyle intervention to prevent diabetes during the first 2 years after childbirth.
  
  
  METHODS
  Qualitative study using semi-structured interviews with women who had gestational diabetes. In phase 1 (31 women), interviews explored the experience of gestational diabetes, ideas about future risk of diabetes and factors influencing post-natal health-related behaviours. Statements were developed summarizing women's views of lifestyle change to prevent diabetes. In phase 2 (14 women), interviews explored how the passage of time had contributed to changes in health behaviour, and the statements were used to develop views about diabetes interventions.
  
  
  RESULTS
  Women were aware of their risk of developing diabetes, but did not always act on such knowledge. Pregnancy motivated behaviour changes to benefit the unborn child, but after delivery these changes were often not maintained. Tiredness, maternal attachment and childcare demands were prominent barriers in the early post-natal months. Later, work, family and child development became more significant barriers. Many women became more receptive to healthy eating messages around the time of weaning. Women were positive about long-term support for self-management to reduce their diabetes risk.
  
  
  CONCLUSIONS
  There is potential to reduce the risk of Type 2 diabetes post-natally among women with gestational diabetes. Interventions need to be developed that take into account contextual factors and competing demands, are flexible and respond to women's individual circumstances. Randomized trials of such interventions are warranted.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: M L S
authors.initials: ML
authors.lastname: Lie
authors.forename: L
authors.initials: L
authors.lastname: Hayes
authors.forename: N J
authors.initials: NJ
authors.lastname: Lewis-Barned
authors.forename: C
authors.initials: C
authors.lastname: May
authors.forename: M
authors.initials: M
authors.lastname: White
authors.forename: R
authors.initials: R
authors.lastname: Bell
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D004739:England / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008425:Maternal Behavior; D049590:Postpartum Period; D057285:Precision Medicine; D011247:Pregnancy; D012306:Risk; D055815:Young Adult