Does diagnosis of gestational diabetes provide a "teachable moment"?

Abstract

Background: In order to control blood glucose levels, women diagnosed with gestational diabetes mellitus (GDM) are required to adapt their diet, monitor glucose levels, and in some cases take medication to avoid serious health complications. Research regarding the determinants of adherent behaviour among women diagnosed with GDM is limited. Methods: This study employed a quantitative longitudinal design. Fifty-nine participants completed a questionnaire at diagnosis, and reported adherence to glucose monitoring, dietary recommendations and medication one month later. Forced entry linear regression was used to examine the prospective relationship between social support, self-efficacy, intention to adhere, the psychosocial factors identified in the TM model (change in affect, risk perception and identity), and adherence. Findings: Levels of self-reported adherence were high, and regression analysis revealed that higher levels of risk perception and social support were significantly associated with higher levels of adherence at follow-up. All participants rated their identity as 'mother to be' important, and the majority reported an increase in negative affect following GDM diagnosis. These two factors were not related to levels of adherence at follow-up. Conclusions: The participants in this sample reported changes in the dimensions outlined by the TM model. Future interventions designed to increase adherence may benefit from a focus on risk perception and social support, as these factors appear to be most strongly associated with adherence to GDM treatment recommendations.