School of Nursing, The University of North Carolina, Chapel Hill, North Carolina 27599-7460, NC, United States.
Faculty of Medicine, Ramathibodi School of Nursing, Ramathibodi Hospital, Mahidol University 270 Bangkok 10400, Thailand.
Curr Diabetes Rev. 2023;19(6):e270622206400. doi: 10.2174/1573399819666220627111430.
Pregnant women with pre-existing type 2 diabetes mellitus (T2DM) are at risk of poor maternal and neonatal health outcomes. Previous systematic reviews on pregnant women with T2DM have focused on physical activity, blood glucose monitoring, and insulin injections.
The purpose of this scoping review was to examine the barriers and facilitators to diabetes self-management in pregnant women with pre-existing type 2 diabetes mellitus.
PubMed, CINAHL, and EMBASE databases were searched using the PRISMA-ScR guidelines. Inclusion criteria included manuscripts written in English and qualitative studies. Consensus statements were excluded. A metasummary was used to identify patterns in barriers and facilitators across studies. A vote-counting method was used to summarize qualitative findings.
A total of ten qualitative publications were selected. This review suggests four themes describing barriers, including barriers to diabetes self-management in pregnancy, stress related to pregnancy with diabetes, a barrier to access to health care, and sensing a loss of control. The fifth theme described facilitators of diabetes self-management in pregnancy.
This supports an integrative model of maternity care and culturally relevant practices to overcome critical barriers and optimize key facilitators to enhance diabetes self-management behaviors and improve maternal and neonatal health outcomes.
患有 2 型糖尿病（T2DM）的孕妇存在母婴健康结局不良的风险。之前关于 T2DM 孕妇的系统评价主要集中在身体活动、血糖监测和胰岛素注射上。
本次范围性审查旨在探讨患有 2 型糖尿病的孕妇进行糖尿病自我管理的障碍和促进因素。
根据 PRISMA-ScR 指南，检索了 PubMed、CINAHL 和 EMBASE 数据库。纳入标准包括以英文撰写的论文和定性研究。共识声明被排除在外。使用元总结来确定研究之间障碍和促进因素的模式。使用投票计数法总结定性发现。
共选择了十篇定性出版物。这篇综述提出了四个主题来描述障碍，包括妊娠期糖尿病自我管理障碍、与妊娠相关的压力、获得医疗保健的障碍以及感觉失去控制。第五个主题描述了妊娠期糖尿病自我管理的促进因素。
这支持了综合的产妇护理模式和文化相关实践，以克服关键障碍并优化关键促进因素，从而增强糖尿病自我管理行为并改善母婴健康结局。
