Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

Abstract

Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative study aimed to evaluate health care providers' perceptions of care responsibilities and resources related to reducing type 2 diabetes risk among women with previous GDM in Singapore. Health care providers acknowledged a shared responsibility. They felt that they had less understanding of compliance with long-term maintenance of lifestyle change, exacerbated further by fragmentation of follow-up care. The application of more integrated patient-centered care models, combined with greater health literacy, is urgently required in this area.

Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians’ views

“…‘No proper system to identify and retain patients in the current care model.’ (primary care clinician) 21 …”

“… 20 Singaporean participants contrasted their system to the Australian one, where a national registry of patients facilitated systematic follow-up. 21 …”

“…Generally, screening was felt to fit better within primary care where there was better continuity of care. 21 However, the postpartum period left little time for the transition to community care to occur, and it often took longer than 13 weeks before Australian primary care clinicians saw the patient. 20 Furthermore, their clinician needed to know of their history of GDM and their responsibility to perform a screening test.…”

“… 23 Even though many clinicians were aware of the need for screening, a heavy patient load and already limited time per patient created a challenging environment for testing. 21 , 23 Furthermore, some health services lacked physical resources, with centres either not set up for testing or lacking capacity or funding to offer it. 23 – 25 …”

Facilitators and Barriers to Post-partum Diabetes Screening Among Mothers With a History of Gestational Diabetes Mellitus–A Qualitative Study From Singapore

“…Fok et al also reported that Chinese mothers (83.7%) were least likely to bring their child outside the home compared to Indians (79.9%) and Malays (66.1%) ( 27 ). If possible, mothers can consider seeking help in looking after their child from their parents, in-laws, spouses, siblings, or even trusted neighbors while they attend their postnatal physician visits ( 28 ). Public and social policies such as paternity leave for fathers ( 29 ) or encouraging young families to stay near to their parents through housing incentives ( 30 ) may also help to address this barrier.…”