Diabetes Prevention, Health Promotion Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark.
Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Copenhagen, Denmark.
Int J Environ Res Public Health. 2020 Apr 28;17(9):3062. doi: 10.3390/ijerph17093062.
Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%-35% of pregnant women develop GDM. In this study, we investigated women's experiences with the dietary and pharmaceutical treatment for GDM in rural and urban Tamil Nadu, India. Semi-structured interviews were conducted with 19 women diagnosed with GDM. Data were analyzed using qualitative content analysis. Three overall aspects were discovered with several sub-aspects characterizing women's experiences: emotional challenges (fear and apprehension for the baby' health and struggling to accept a treatment seen as counterintuitive to being safe and healthy), interpersonal challenges (managing treatment in the near social relations and social support, and coordinating treatment with work and social life), and health system-related challenges (availability and cost of treatment, interaction with health care providers). Some aspects acted as barriers. However, social support and positive, high-quality interactions with health care providers could mitigate some of these barriers and facilitate the treatment process. Greater efforts at awareness creation in the social environment and systemic adjustments in care delivery targeting the individual, family, community and health system levels are needed in order to ensure that women with GDM have the opportunity to access treatment and are enabled and motivated to follow it as well.
妊娠期糖尿病（GDM）与一系列不良妊娠结局以及未来患 2 型糖尿病和心血管疾病的风险增加有关。在印度，10%-35%的孕妇患有 GDM。在这项研究中，我们调查了印度泰米尔纳德邦农村和城市地区妇女对 GDM 的饮食和药物治疗的体验。对 19 名被诊断患有 GDM 的妇女进行了半结构化访谈。使用定性内容分析对数据进行了分析。发现了三个总体方面，并有几个亚方面描述了妇女的体验：情绪挑战（对婴儿健康的恐惧和担忧，以及难以接受被视为不安全和健康的治疗）、人际挑战（在近社会关系和社会支持中管理治疗，以及协调治疗与工作和社会生活）以及与卫生系统相关的挑战（治疗的可及性和成本，与医疗保健提供者的互动）。有些方面是障碍。然而，社会支持和与医疗保健提供者的积极、高质量互动可以减轻其中一些障碍，并促进治疗过程。需要在社会环境中加大宣传力度，并在针对个人、家庭、社区和卫生系统各级的护理提供方面进行系统性调整，以确保患有 GDM 的妇女有机会获得治疗，并能够并愿意遵循治疗。
