New Zealand women’s experiences of managing gestational diabetes through diet: a qualitative study

Abstract

Background For women with gestational diabetes mellitus (GDM) poor dietary choices can have deleterious consequences for both themselves and their baby. Diet is a well-recognised primary strategy for the management of GDM. Women who develop GDM may receive dietary recommendations from a range of sources that may be inconsistent and are often faced with needing to make several dietary adaptations in a short period of time to achieve glycaemic control. The aim of this study was to explore how women diagnosed with GDM perceive dietary recommendations and how this information influences their dietary decisions during pregnancy and beyond. Methods Women diagnosed with GDM before 30 weeks’ gestation were purposively recruited from two GDM clinics in Auckland, New Zealand. Data were generated using semi-structured interviews and thematic analysed to identify themes describing women’s perceptions and experiences of dietary recommendations for the management of GDM. Results Eighteen women from a diverse range of sociodemographic backgrounds participated in the study. Three interconnected themes described women’s perceptions of dietary recommendations and experiences in managing their GDM through diet: managing GDM is a balancing act; using the numbers as evidence, and the GDM timeframe. The primary objective of dietary advice was perceived to be to control blood glucose levels and this was central to each theme. Women faced a number of challenges in adhering to dietary recommendations. Their relationships with healthcare professionals played a significant role in their perception of advice and motivation to adhere to recommendations. Many women perceived the need to follow dietary recommendations to be temporary, with few planning to continue dietary adaptations long-term. Conclusions The value of empathetic, individually tailored advice was highlighted in this study. A greater emphasis on establishing healthy dietary habits not just during pregnancy but for the long-term health of both mother and baby is needed.

The Complexities of Managing Gestational Diabetes in Women of Culturally and Linguistically Diverse Backgrounds: A Qualitative Study of Women’s Experiences

“…Consistent with previous studies, revealing that it is difficult for women to implement dietary changes when staple cultural foods are ”carbohydrate heavy” [ 16 , 21 ], the women in our study described how common cultural foods were incompatible with their GDM management. Nutritional advice varied, with some women having been advised to avoid these cultural foods completely, while others were informed to eat their cultural foods in smaller portions or at certain times.…”

“…Conflicting advice such as this occurs when dietitians lack education about variations in cultural cuisines, resulting in women sacrificing these dishes [ 17 , 21 ]. As a result, women undertook research and sought advice within their communities to make substitutions that better replicate their usual diet [ 16 , 17 ]. We observed this solution focus in our sample, where women substituted foods (multi-grain flour instead of wheat flour) and employed alternative cooking methods (boiling and grilling) to enable them to continue eating cultural foods while managing their GDM.…”

“…In some cultures, GDM is unheard of or goes unspoken. Therefore, when diagnosed, women experience a sense of isolation [ 16 ], are often left to do their own research and may seek advice within their communities [ 16 , 17 ], or the advice they receive conflicts with their cultural practices and beliefs regarding pregnancy [ 12 ].…”

Women's experiences with managing advice on gestational diabetes - a qualitative interview study

“…The midwives experienced conflicting encounters providing antenatal care to pregnant women with GDM [11]. In a New Zealand study, women with GDM experienced that their relationships with healthcare professionals played a significant role in their motivation to adhere to recommendations, and the value of individually tailored advice was highlighted in the study [12]. Therefore, the present study aims to gain insight into the experiences, thoughts, and feelings of women with GDM, who are faced with advice for changing lifestyle, and use these insights to discuss the approach to the individual woman in preventive measures targeting GDM.…”