Factors Influencing Self-Management in Gestational Diabetes Mellitus: Insights from Women, Caregivers, and Providers through a Mixed-Methods Approach
1
Public Health, Independent University, Bangladesh, Dhaka, Bangladesh
2
Public Health, Northern Uniuversity Bangladesh, Dhaka, Bangladesh
3
Smart Healthcare and Research Ltd, Dhaka, Bangladesh
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The rising prevalence of diabetes in pregnancy poses a severe public health burden in Bangladesh, highlighting the need for effective national guidelines for GDM management. Addressing health system and patient-level barriers through comprehensive interventions is essential to reduce its consequences. Few studies in Bangladesh have examined factors influencing non-adherence to GDM self-management and the roles of caregivers and healthcare providers. So, this study aimed to identify these issues.
METHODS:
This cross-sectional mixed-methods study included 251 GDM patients and their caregivers for the quantitative component, and 12 healthcare professionals (physicians, nurses, nutritionists) from four hospitals for the qualitative component. Quantitative data were collected through face-to-face interviews using a pre-tested semi-structured questionnaire and the Diabetes Self-Management Questionnaire (DSMQ), while qualitative data were gathered via key informant interviews. Univariate and multivariate analyses were conducted, with p<0.05 considered statistically significant, and qualitative findings were analyzed thematically.
RESULTS:
This unique study revealed that the majority of women with GDM exhibited suboptimal self-care in diabetes management (68.5%), including glucose control (82.5%), dietary controls (75.7%), physical activity (73.3%), and healthcare use (43.8%). Significant characteristics associated with sub-optimal self-care included nuclear (OR: 4.70) & combined family (OR: 3.88), a positive family history of diabetes (OR: 1.73), the presence of comorbidities (OR: 2.46), and a caregiver’s higher level of education (OR: 2.34). Qualitative findings indicate that low education, rural residence, financial constraints, fear, misconceptions about insulin, misinformation, social stigma, and inconsistent caregiver support drive poor adherence to GDM self-management. In contrast, educated and multiparous women demonstrate better compliance.
CONCLUSIONS:
Most women with GDM showed poor self-care, especially in glucose control, diet, physical activity, and healthcare use, influenced by socio-demographic and clinical factors. Targeted education and support programs are needed to improve self-care.
The rising prevalence of diabetes in pregnancy poses a severe public health burden in Bangladesh, highlighting the need for effective national guidelines for GDM management. Addressing health system and patient-level barriers through comprehensive interventions is essential to reduce its consequences. Few studies in Bangladesh have examined factors influencing non-adherence to GDM self-management and the roles of caregivers and healthcare providers. So, this study aimed to identify these issues.
METHODS:
This cross-sectional mixed-methods study included 251 GDM patients and their caregivers for the quantitative component, and 12 healthcare professionals (physicians, nurses, nutritionists) from four hospitals for the qualitative component. Quantitative data were collected through face-to-face interviews using a pre-tested semi-structured questionnaire and the Diabetes Self-Management Questionnaire (DSMQ), while qualitative data were gathered via key informant interviews. Univariate and multivariate analyses were conducted, with p<0.05 considered statistically significant, and qualitative findings were analyzed thematically.
RESULTS:
This unique study revealed that the majority of women with GDM exhibited suboptimal self-care in diabetes management (68.5%), including glucose control (82.5%), dietary controls (75.7%), physical activity (73.3%), and healthcare use (43.8%). Significant characteristics associated with sub-optimal self-care included nuclear (OR: 4.70) & combined family (OR: 3.88), a positive family history of diabetes (OR: 1.73), the presence of comorbidities (OR: 2.46), and a caregiver’s higher level of education (OR: 2.34). Qualitative findings indicate that low education, rural residence, financial constraints, fear, misconceptions about insulin, misinformation, social stigma, and inconsistent caregiver support drive poor adherence to GDM self-management. In contrast, educated and multiparous women demonstrate better compliance.
CONCLUSIONS:
Most women with GDM showed poor self-care, especially in glucose control, diet, physical activity, and healthcare use, influenced by socio-demographic and clinical factors. Targeted education and support programs are needed to improve self-care.
| eISSN: | 2654-1459 |
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