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Enablers and Barriers to Self-Management of Gestational Diabetes Mellitus: A Systematic Literature Review of Stakeholder Views
ABSTRACT
Background:
The prevalence of gestational diabetes mellitus is rapidly increasing at epidemic proportions making it the most common metabolic disorder of pregnancy. Many disparities exist between target recommendations from various international professional organisations resulting in a lack of global consensus. Further, GDM treatment largely relies on self-management and rapid adaptations within a short timeframe. Some studies have reported women’s experiences of having GDM, but little is known how this relates to self-management.
Objective:
The aim of this study was to identify enablers and barriers for women with GDM to self-management in the current Australian healthcare system.
Methods:
In this study, 4 databases were searched and a total of 16 studies, consisting of 799 stakeholder views were finally included.
Results:
The single most reported barriers echoed by both healthcare professionals and women with GDM was the fractured healthcare system. This barrier far surpassed the second and third most common barriers, insufficient education, and dietary limitations, respectively. On the other hand, the most common enablers to GDM self-management were a lack of diabetes education or guidance, and the motivation to live healthier. This was reassuring as motivation is often driven by empowerment or intrinsic factors. Utilising digital health interventions provides convenience and improves health literacy thereby overcoming some of these barriers. Due to the high heterogeneity of the studies, a meta-analysis could not be performed highlighting the need for increased research in this space.
Conclusions:
Although self-management of GDM remains challenging, there are motivating enablers that the healthcare system can work on to improve health outcomes for women with GDM. Empowering women to become active stakeholders, whilst also addressing better communication, alignment, and accountability is essential to enhancing GDM self—management.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.