Understanding Patient Perceptions of Genetic Testing to Predict Type 2 Diabetes Risk After Gestational Diabetes

Women with gestational diabetes mellitus (GDM) face increased lifetime risk of type 2 diabetes (T2DM). Genetic risk-predictive testing could help identify those at highest risk and guide preventative care. We aimed to assess perceptions of genetic risk scores to help inform future implementation.

An online survey of 112 women with current or prior GDM assessed willingness for genetic and non-genetic risk testing, attitudes, lifestyle motivation, and data-use concerns. Quantitative analyses were complemented by thematic analysis of free-text responses.

Overall, willingness was high for both genetic testing (83.9%) and non-genetic (90.2%), with no significant difference between them (p = 0.083). Participants identifying as White reported greater willingness for genetic testing (p = 0.020) and stronger agreement that testing should be available on the NHS (p = 0.032) than Non-White participants. Attitudes toward genetic testing were positive and associated with both willingness to test and support for NHS availability (p < 0.001). Younger participants were more motivated to modify lifestyle behaviours (p = 0.015). Overall, concerns around data collection were low; although free-text responses highlighted health insurance implications, psychological burden, actionability of results, and timing of testing as salient themes.

Women with GDM were receptive to genetic risk-prediction for T2DM, with low concerns around data usage. Demographic differences in acceptability and motivation highlight the need for inclusive, targeted communications and lifestyle support alongside integration testing into postnatal-GDM care.