Title of project

Prevention of type 2 diabetes in young couples at high risk – Investigating shared risk and family dynamics among couples with a history of gestational diabetes

Abstract

Aim: The overall aim is to investigate the shared type 2 diabetes (T2D) risk factors among young couples, where the woman has a high risk of developing T2D due to a previous pregnancy with gestational diabetes mellitus (GDM), as well as to investigate the importance of social support and family dynamics in that context.

Background and significance: Women with a history of GDM have an 18-fold higher risk of T2D in the first decade after delivery compared to normoglycemic pregnant women. T2D risk can be reduced in women with prior GDM. However, many intervention studies have shown disappointing results. One important barrier is the lack of support from the partner. Interestingly, some studies suggest that the partner may also have an elevated T2D risk. Addressing the potential shared risk between couples and factors operating at the family level may have immense potential to develop targeted long-term prevention in the form of family health promotion. It is unclear how and to what degree partner support and family dynamics influence behaviour change and, thus, T2D risk in women with prior GDM and their partners.

Research design and methods: The Face-it study is a large Danish randomized controlled trial evaluating a multi-site cross-sectorial health promotion intervention seeking to improve the quality of life and reduce the risk of T2D in couples where the woman recently had GDM. Data is collected from the woman and partner at clinical examinations and from questionnaires 3 months and 12 months after delivery.

Data applied: Clinical T2D risk factors: fasting glucose and insulin, HbA1c, blood lipids, anthropometrics, fat mass percentage, and blood pressure. Health behaviors: Diet, physical activity, smoking, and alcohol), family dynamics, social support: life quality, and psychosocial factors.

Logistic regression analysis will be used to estimate Odds Ratio for clinical T2D risk factors in the woman and her partner. A multiple linear regression model will be used to investigate the association between family dynamics, social support, clinical T2D risk factors, and health behaviors. Intervention effects will be investigated using linear mixed models. Lastly, we will apply causal mediation analysis to dissect the total effect of the Face-it intervention into direct and indirect effects.