Other Titles
Sustaining a Sense of Unknowing About the Risk for Coronary Artery Disease Following a Diagnosis of Gestational Diabetes Mellitus [Title Slide]
Abstract
Background: Coronary artery disease (CAD) is a major global health issue (Khan et al., 2020; Roth et al., 2017; Virani et al., 2021) and affects many women, with one death every 16 minutes in Canada (Heart and Stroke Foundation of Canada, 2023; Norris & Mulvagh, 2024). Gestational diabetes mellitus (GDM), a rising non-traditional CAD risk factor (Garcia et al., 2016; Mussa et al., 2021; Saeedi et al., 2019), increases women’s CAD risk fourfold (Garcia et al., 2016). Despite this, women often lack knowledge of the long-term risks associated with GDM (Craig et al., 2020; Khooshehchin et al., 2016; Lennon, 2018; Sandsaeter et al., 2019). This grounded theory study examines how women with prior GDM understand and give meaning to their CAD risk and how these perceptions influence their health behaviours.
Methods: This research study was guided by a GT approach. Semi-structured interviews were conducted with women who had GDM living in Newfoundland and Labrador (NL). The constant comparative method was used to facilitate data collection and analysis.
Results: The substantive theory that emerged from the study findings was Making the Shift from Unknowing to Knowing and Living With the Risk for CAD After Having had GDM. Twenty-six women from NL with a history of GDM and living in NL participated. The theoretical construct Sustaining a Sense of Unknowing About the Risk for Coronary Artery Disease Following a Diagnosis of Gestational Diabetes Mellitus captures participants’ experiences as they conclude that they do not face future health risks once the GDM resolves. Two categories comprised this process: 1) Communicating Risk, and 2) Drawing Conclusions About One’s Risk.
Conclusions: Strengthened risk communication and education by interdisciplinary healthcare professionals, including nurses and nurse practitioners, are essential to help women understand their long-term CAD risk after GDM, given the critical role nurses play in education and follow-up within primary care and postpartum settings. The findings underscore the need for evidence-informed clinical practice guidelines and policies that promote appropriate CAD screening and long-term follow-up for women with prior GDM. Implementing these guidelines may help prevent CAD in this high-risk population.
Notes
Presenter notes available in attached slide deck. To see the notes in Adobe Acrobat, go to Tools > Comment or look at your Layers Panel. If the notes were saved as comments or layers, you can toggle them visible.
References:
Craig, L., Sims, R., Glasziou, P., & Thomas, R. (2020). Women’s experiences of a diagnosis of gestational diabetes mellitus: a systematic review. Pregnancy and Childbirth, 20(76). https://doi.org/10.1186/s12884-020-2745-1
Garcia, M., Mulvagh, S. L., Bairey Merz, C. N., Buring, J. E., & Manson, J. E. (2016). Cardiovascular disease in women: Clinical perspectives. Circulation Research, 118(8), 1273–1293. https://doi.org/10.1161/CIRCRESAHA.116.307547
Heart and Stroke Foundation of Canada. (2023). System failure: Healthcare inequities continue to leave women’s heart and brain health behind. Retrieved from https://issuu.com/heartandstroke/docs/h_s_women_s_report_february_2023?fr=sNGQ5NTUzMjYzODY
Khan, M. A., Hashim, M. J., Mustafa, H., Baniyas, M. Y., Al Suwaidi, S. K. B. M., AlKatheeri, R., Alblooshi, F. M. K., Almatrooshi, M. E. A. H., Alzaabi, M. E. H., & Al Darmaki, R. S. (2020). Global epidemiology of ischemic heart disease: Results from the global burden of disease study. Cureus, 12(7). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384703/
Khooshehchin, T. E., Keshavarz, Z., Afrakhteh, M., Shakibazedeh, E., & Faghihzadeh, S. (2016). Perceived needs in women with gestational diabetes: A qualitative study. Electron Physician, 8(12), 3412-3420. doi: 10.19082/3412
Lennon, S. L. (2018). Perception of pregnancy risk among women with gestational diabetes and their partners: A mixed methods study. [Doctoral Dissertation, University of Manitoba]. http://hdl.handle.net/1993/33686
Mussa, J., Meltzer, S., Bond, R., Garfield, N., & Dasgupta, K. (2021). Trends in national Canadian guideline recommendations for the screening and diagnosis of gestational diabetes mellitus over the years: A scoping review. International Journal of Environmental Research and Public Health, 18(4), 1454. https://www.mdpi.com/1660-4601/18/4/1454
Norris, C. M., & Mulvagh, S. L. (2024). Looking after her heart; Let’s talk about women’s heart health. Canadian Journal of Cardiology Open, 6(2), 139-141.
Roth, G. A., Johnson, C., Abajobir, A., Abd-Allah, F., Abera, S. F., Abyu, G., Ahmed, M., Aksut, B., Alam, T., Alam, K., Alla, F., Alvis-Guzman, N., Amrock, S., Ansari, H., Ärnlöv, J., Asayesh, H., Atey, T. M., Avila-Burgos, L., Awasthi, A., … Murray, C. (2017). Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. Journal of the American College of Cardiology, 70(1), 1–25. https://doi.org/10.1016/j.jacc.2017.04.052
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Uwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045. Diabetes Research and Clinical Practice, 157. doi: 10.1016/j.diabres.2019.107843.
Sandseater, H. L., Horn, J., Rich-Edwards, J. W., & Haugdahl, H. S. (2019). Preeclampsia, gestational diabetes and later risk of cardiovascular disease: Women’s experiences and motivation for lifestyle changes explored in focus group interviews. BMC, 448. https://doi.org/10.1186/s12884-019-2591-1
Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., Elkind, M. S. V., Evenson, K. R., Feruson, J. F., Gupta, D. K., Khan, S. S., Kissela, B. M., Knutson, K. L., Lee, C. D., …& Tsao, C. W. (2021). Heart disease and stroke statistics. Circulation, 143. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html
Sigma Membership
Xi Lambda
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Grounded Theory
Research Approach
Qualitative Research
Keywords:
Policy and Advocacy, Interprofessional Initiatives, Health Equity or Social Determinants of Health, Gestational Diabetes Mellitus, Cardiovascular Risk Factors
Recommended Citation
Baldwin, Daisy, "Sustaining a Sense of Unknowing of the Risk for Coronary Artery Disease After Gestational Diabetes" (2026). International Nursing Research Congress (INRC). 111.
https://www.sigmarepository.org/inrc/2026/presentations_2026/111
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-03
Sustaining a Sense of Unknowing of the Risk for Coronary Artery Disease After Gestational Diabetes
Toronto, Ontario, Canada
Background: Coronary artery disease (CAD) is a major global health issue (Khan et al., 2020; Roth et al., 2017; Virani et al., 2021) and affects many women, with one death every 16 minutes in Canada (Heart and Stroke Foundation of Canada, 2023; Norris & Mulvagh, 2024). Gestational diabetes mellitus (GDM), a rising non-traditional CAD risk factor (Garcia et al., 2016; Mussa et al., 2021; Saeedi et al., 2019), increases women’s CAD risk fourfold (Garcia et al., 2016). Despite this, women often lack knowledge of the long-term risks associated with GDM (Craig et al., 2020; Khooshehchin et al., 2016; Lennon, 2018; Sandsaeter et al., 2019). This grounded theory study examines how women with prior GDM understand and give meaning to their CAD risk and how these perceptions influence their health behaviours.
Methods: This research study was guided by a GT approach. Semi-structured interviews were conducted with women who had GDM living in Newfoundland and Labrador (NL). The constant comparative method was used to facilitate data collection and analysis.
Results: The substantive theory that emerged from the study findings was Making the Shift from Unknowing to Knowing and Living With the Risk for CAD After Having had GDM. Twenty-six women from NL with a history of GDM and living in NL participated. The theoretical construct Sustaining a Sense of Unknowing About the Risk for Coronary Artery Disease Following a Diagnosis of Gestational Diabetes Mellitus captures participants’ experiences as they conclude that they do not face future health risks once the GDM resolves. Two categories comprised this process: 1) Communicating Risk, and 2) Drawing Conclusions About One’s Risk.
Conclusions: Strengthened risk communication and education by interdisciplinary healthcare professionals, including nurses and nurse practitioners, are essential to help women understand their long-term CAD risk after GDM, given the critical role nurses play in education and follow-up within primary care and postpartum settings. The findings underscore the need for evidence-informed clinical practice guidelines and policies that promote appropriate CAD screening and long-term follow-up for women with prior GDM. Implementing these guidelines may help prevent CAD in this high-risk population.
Description
This presentation examines how women with prior gestational diabetes understand and interpret their coronary artery disease risk, revealing communication gaps and emphasizing the need for evidence-based education and follow-up to improve cardiovascular outcomes.