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How can gestational diabetes care be improved?

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The experiences of Australian women with prior gestational diabetes – the good, the bad and what should be improved

By Dr Joanne Jordan

Gestational diabetes (GDM) is a form of diabetes that develops during pregnancy and usually resolves after birth. In Australia, 17% of pregnancies are affected by GDM, which can increase pregnancy and birth complications. Women with prior gestational diabetes are also at a higher risk of developing type 2 diabetes in the future. GDM is managed through diet, exercise, monitoring of blood glucose levels and sometimes, medication. Being diagnosed with GDM often comes as a shock and adds a burden of stress. 

An Australian study, which included ACBRD’s Liz Holmes-Truscott, asked over 800 women about their GDM lived experiences. Participants completed an online survey about their positive and negative experiences, information that was helpful and what could be improved.

What helped women in managing GDM? 

    • Access to healthcare professionals (HCPs), such as diabetes educators, who took time to help women learn, understand and discuss GDM.
    • Being able to quickly resolve GDM self-management issues with their HCP.
    • Having concerns taken seriously by HCPs who showed empathy and support.
    • Getting consistent care across HCPs.
    • Some women also found apps and telehealth services helpful to manage GDM.s

What was challenging for women in managing GDM? 

    • Differences in how GDM is diagnosed in Australia (e.g. different blood glucose level cut-offs)  and internationally.  
    • GDM management not being tailored to a person’s needs.  
    • Feeling blamed or being judged by HCPs, friends and family for having GDM (stigma) as well as their own feelings of guilt.
    • Lack of telehealth options for appointments, notably for those in rural areas. 

How should care be improved for women with GDM? 

    • More GDM information: 
      • At diagnosis, so women can understand, early on, the causes of GDM and the impact on pregnancy and labour.  
      • After birth, so women can understand the risks and strategies to prevent type 2 diabetes in the future.
    • Better person-centred care: 
      • Having care and support tailored to meet individual needs. 
      • Access to emotional health support, for example to assist with GDM stigma.   
      • Being involved in decisions about care. 
      • Receiving care and information without blame, judgement or shame.
    • Greater use of digital health options for care: 
      • Increase use of telehealth, particularly in rural areas. 
      • Use of apps and other digital tools as part of GDM management.  

This study highlights the need to deliver more person-centred GDM care in the Australian healthcare setting.  

To read more of our research on gestational diabetes, see our previous blogs

To learn more about diabetes and emotional health, explore our fact sheets


Reference:

Roesler A, Butten K, Taylor P, Morrison M, Varnfield M, Holmes-Truscott E. The experiences of individuals who have had gestational diabetes: A qualitative exploration. Diabetic Medicine. 2024; 00:e15374. doi:10.1111/dme.15374  

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