Figueroa Gray Marlaine, Hsu Clarissa, Kiel Linda, Dublin Sascha
Group Health Research Institute, 1730 Minor Avenue, Suite 1280, Seattle, WA, USA.
Matern Child Health J. 2017 Aug;21(8):1678-1685. doi: 10.1007/s10995-017-2261-8.
Objectives Gestational Diabetes Mellitus (GDM) affects hundreds of thousands of women each year. Many require medications to manage their blood glucose levels. Only insulin is approved by the U.S. Food and Drug Administration for use in pregnancy. While other medications can be used, their safety remains controversial. Few studies have examined women's lived experience of using insulin for GDM. Our objective in this study was to foreground the voices of women speaking about their treatment experience. Methods We conducted two focus groups including 16 women treated for GDM with medications, primarily insulin. Topics included women's experiences with GDM diagnosis and treatment including concerns about risks and benefits of treatments. Transcripts were analyzed using an inductive coding approach. Results Many women had negative experiences with insulin use, such as feeling that they had no voice in treatment decisions, and received inadequate information about insulin, including about the impact it would have on their daily lives. Many continued to have difficulty managing their blood sugar once on insulin, and they worried about the short term and long term health effects of insulin on themselves and their babies. They wanted more information about non-insulin treatment options as well as more social support. Conclusion In our sample of women with GDM, insulin treatment resulted in negative experiences with emotional and experiential impacts lasting beyond pregnancy. There is a need for more research on other medications for GDM, so that women can have access to more treatment options and better information to guide their choices.
目标 妊娠期糖尿病（GDM）每年影响着成千上万的女性。许多患者需要药物来控制血糖水平。美国食品药品监督管理局仅批准胰岛素可用于孕期。虽然也可使用其他药物，但其安全性仍存在争议。很少有研究探讨女性使用胰岛素治疗妊娠期糖尿病的实际经历。我们这项研究的目的是突出女性讲述其治疗经历的声音。方法 我们开展了两个焦点小组，共有16名接受过妊娠期糖尿病药物治疗（主要是胰岛素治疗）的女性参与。话题包括女性妊娠期糖尿病的诊断和治疗经历，以及对治疗风险和益处的担忧。使用归纳编码方法对访谈记录进行分析。结果 许多女性在使用胰岛素方面有负面经历，比如感觉自己在治疗决策中没有话语权，并且在胰岛素相关信息方面了解不足，包括胰岛素对她们日常生活的影响。许多女性在开始使用胰岛素后血糖管理仍有困难，她们担心胰岛素对自己和宝宝的短期及长期健康影响。她们希望获得更多关于非胰岛素治疗方案的信息以及更多社会支持。结论 在我们的妊娠期糖尿病女性样本中，胰岛素治疗带来了负面经历，其情感和实际影响持续到产后。有必要对妊娠期糖尿病的其他药物进行更多研究，以便女性能够获得更多治疗选择和更好的信息来指导她们做出选择。
