Values, principles and research priorities for the implementation of type 2 diabetes prevention after gestational diabetes: A global consensus from Asia, Africa, Americas, Europe and Oceania

Abstract

Aims: The implementation of type 2 diabetes prevention after gestational diabetes (GDM) is poor despite research evidence on efficacy. This is limited by the lack of knowledge of the priorities in real-world settings from the perspectives of local clinicians and women with lived experiences, particularly those from underserved populations. We report here a global consensus on the values, principles, and research priorities for the implementation of type 2 diabetes prevention in individuals after gestational diabetes (GDM), from the perspectives of clinicians and women from Asia, Africa, Oceania, the Americas, and Europe. Methods: A team of health professionals and researchers from five continents formed the Cardiometabolic Health Implementation Research in Postpartum individuals (CHIRP) team. The CHIRP team undertook a priority setting process using the Modified Delphi and Nominal Group Technique. Health professionals and women with a lived experience of GDM from five continents were invited to participate. Values, principles, and research priorities were voted on by all participants. Results: A total of 100 consumers and health professionals from 11 countries across the five continents participated in the consensus process. The top-ranked values and principles were ‘universal access’, ‘evidence-based’, and ‘equity-driven’. The top-ranked research priorities were ‘stress and mental well-being’, ‘information on exercise and diet’, ‘lactation and breastfeeding’, ‘exercise after childbirth’, and ‘physical environment for healthy eating’. Conclusions: Addressing mental wellbeing through strategies that are universally accessible, evidence-based, and equity-driven will increase the success of the real-world implementation and knowledge translation of type 2 diabetes prevention in women with a history of GDM in global settings.