Women's Health Education and Diabetes: Raising Awareness of Preconception Planning.

To reduce the risk of miscarriages, complications of pregnancy, and fetal abnormalities, women with diabetes need to plan pregnancies and achieve near normal glycemic control prior to conception. However, 58% of pregnancies among women with diabetes are unplanned. This pilot study evaluated the impact of a 90-minute women's health class on clinical and psychosocial factors of 78 adult women with diabetes who are not currently pregnant (85% with type 1, 42% married, 86% white; age 30±6yrs, duration 16±9yrs, education=164±2 years; A1c 7.7±1.7%). Attendees reported health and birth-control practices and completed measures of diabetes quality of life (DQOL), self esteem (Rosenberg scale), optimism (LOT-R), Self-Mastery Scale (SMS), diabetes distress (PAID), Coping Styles, depression (CES-D), self care (SCI-R), frustration with self-care, and social support (SPS) at baseline and 3 months post class. At baseline, 61% of women had A1c≥7.0%. Of those, 50% plan to have children in the near future. 55 women are sexually active, 7 of these do not use birth control (of these 7, 4 have A1c>8.0% and 3 have A1c<6.5%). 60 women (77%) currently use birth control: pills (44%), condoms alone (22%), and condoms and another method (22%), and other 10%. Frequency of self-care behaviors was inversely associated with Alc (r=-.43, p=.0001), particularly adherence to medication (r=-.45, p<0.0001) and dietary recommendations (r=-0.32, p<0.01). Frequency of self-care behaviors was also associated with social support (r=0.29, p=0.01). At follow-up the women scored higher on optimism (64.8 vs 68.3, p<0.05), had better quality of life (69.5 vs 71.2, p=0.05), less diabetes distress (26 vs 22, p<0.05), less use of emotional based coping (52.5 vs 49.1, p<0.05), and greater sense of self-mastery (73 vs 78, p<0.01). Reported adherence to dietary recommendations increased (67 vs 71, p<0.05). All attendees found the class helpful in understanding the importance of planning for pregnancy and 80% reported being motivated to make changes to diabetes care. Conclusions: Women with diabetes who plan to have children in the near future need support in achieving and maintaining stringent glycemic targets. This women's health education intervention is helpful in raising awareness of the importance of near normal glycemia prior to pregnancy. [ABSTRACT FROM AUTHOR]