689-P: Type 2 Diabetes Risk Perception and Health Behaviors among Women with History of Gestational Diabetes Mellitus

Introduction & Objective: Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes (T2D). Our goal was to examine the association between perceived risk of developing T2D and health behaviors in this population.

Methods: We analyzed surveys and electronic health records of participants in the GRAND Study, a multisite RCT testing the effectiveness of shared decision-making for women with elevated body mass index (BMI), prediabetes and history of GDM. Data on demographics, health behaviors, and perceived T2D risk were self-reported. We ran four regressions to examine the association between women’s perceived risk of developing T2D and four key health behaviors: 1) physical activity levels, 2) sugar-sweetened beverage consumption, 3) ultra-processed food consumption, and 4) consumption of meals prepared outside the home. All models were adjusted for age, race, ethnicity, income, A1c, BMI, family history of T2D, and study arm.

Results: Our sample included 165 women with a history of GDM, prediabetes, with mean age 41.3 (± 5.6 years) and mean BMI 32.1 (± 6.9 kg/m²). Perceived risk of developing T2D was not significantly associated with physical activity, consumption of sugar-sweetened beverages, or meals prepared outside of the home (p>0.05). However, women reporting lower perceived T2D risk had 2.9 times the odds of less frequent ultra-processed food consumption than those with higher perceived risk (p=.029). Higher BMI was significantly associated with increased consumption of sugar-sweetened beverages (p=0.005), but not other health behaviors.

Conclusion: We found perceived risk of developing T2D was significantly associated with ultra-processed food consumption but not physical activity, consumption of sugar-sweetened beverages, or meals prepared outside the home. Women with GDM are at high risk of developing T2D and may benefit from tailored interventions promoting health behavior changes shown to lower T2D risk.