Self-management and self-efficacy of women with gestational diabetes mellitus: a systematic review

ABSTRACT

Background

Gestational diabetes mellitus (GDM) is a temporary form of diabetes induced by pregnancy and is potentially harmful to both the mother and fetus The impact of GDM diagnosis on pregnant women needs to be taken into account. This is related to the capacity for self-management of GDM, for which quality evidence is still lacking.

Objective

to identify several aspects of self-management and self- efficacy for women with GDM.

Method

Electronic databases were searched for studies related to the self-management, self-efficacy, and glycemic control of women with GDM, from January 2012 to January 2021. The extraction of study features was based on study location, reported research aims, study design, methodology, and the analytical approach, using Endnote Version X7.7.1. The Critical Appraisal Skills Program Qualitative Checklist (CASP) was used to assess quality, as recommended by the Cochrane Qualitative Research Methods Group.

Results

Ten out of 70 studies were identified as meeting the established criteria and including a diverse population. The synthesis revealed seven major themes: preliminary psychological impact, communicating the diagnosis, knowledge of GDM, self-efficacy and self-management of GDM, risk perception, the burden of GDM, and gaining control. The benefits of a diagnosis were behavioral and were mostly crystalized if a particular level of self-management and self-efficacy was reached and women were able to have specific control over their diet and body weight. On the other hand, women reported that the diagnosis increased their responsibility, as they had to take extra precautions regarding their dietary regimen.

Conclusion

Self-management and self-efficacy for GDM management are possible, despite the psychological hurdles that most women confront. There is still potential for improvement in terms of developing a healthy lifestyle that not only manages GDM for the best pregnancy result, but also prevents diabetes after pregnancy.

KEYWORDS:

• Gestational diabetes mellitus
• self-management
• self-efficacy
• glycemic control
• systematic review
• qualitative
• diagnostic

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Acknowledgments

The authors express their gratitude to Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and consent

This review did not involve human subjects; ethical approval was not required.

Paper context

Evidence on self-management of GDM, a common condition due to increased prevalence of pregnancies and obesity, is lacking. Our study showed that despite the challenges and the increased sense of responsibility following the diagnosis, with regards to food control and physical exercise, self-management and self-efficacy through behavioral and lifestyle modification is feasible. This could be further improved by use of mobile applications, whereas online support groups could address possible psychologic repercussion and social isolation.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Wafa Almegewly

Conceived and designed the project: SK. Collected the data: SK,CS. Analyzed the data: SK; WA; AA; HA; CS. Wrote the paper: SK; WA; AA; HA;CS. Prepared and submitted the final draft of the manuscript SK; WA.