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

Abstract

Aim: This study aimed to explore women’s perspectives and experiences concerning how culture impacts the lifestyle management of gestational diabetes mellitus (GDM) in women of culturally and linguistically diverse (CALD) backgrounds. Methods: Women of any cultural background diagnosed with GDM within the previous 12 months were purposively recruited from two Australian metropolitan hospitals. Data collected using semi-structured interviews (n = 18) and focus groups (n = 15 women in three groups) were analysed using reflexive thematic analysis. Results: Three themes were generated: “cultural beliefs and obligations impact lifestyle management of gestational diabetes”, which describes how some cultures lack awareness about GDM, and modifications or restrictions were viewed as depriving the infant, but sometimes adaptions could be made so that a culturally appropriate meal was suitable for GDM management; “the relationship between cultural foods and gestational diabetes management”, which discusses how important cultural foods may be incompatible with appropriate GDM management, so women worked to find solutions; “gestational diabetes education lacks cultural awareness and sensitivity”, which illustrates how current education fails to address differences in cultural beliefs, language and eating practices. Conclusion: Cultural beliefs, obligations and food practices must be considered when assisting women of CALD backgrounds using lifestyle modification to manage GDM. GDM education must be culturally sensitive and competent and, where possible, be delivered by health professionals of a shared cultural group.

Improving women’s experiences with gestational diabetes from culturally and linguistically diverse backgrounds in Australia: a qualitative study

“…One of the main challenges for managing GDM was a lack of culturally specific advice for dietary adjustments, in keeping with evidence from previous studies ( 18 , 23 , 24 ). Surprisingly, even Australian-born women adhering to specific diets, such as vegetarian, found that the dietary advice for managing GDM was inadequate.…”

“…Surprisingly, even Australian-born women adhering to specific diets, such as vegetarian, found that the dietary advice for managing GDM was inadequate. Restricting the consumption of cultural foods and the fear of eating were also reported in other studies (18,(23)(24)(25). Better education about food cultures and diets among health professionals can provide more tailored dietary information to women of all ethnicities.…”

Connecting the Dots of Care: A pilot study linking Aboriginal and/or Torres Strait Islander peoples with diabetes care in hospital, using hospital pharmacists

“… 63 This approach could also benefit other priority groups where stigma around life-style changes can be common (e.g culturally and linguistically diverse populations (CALD) and women who are pregnant). 64 , 65 , 66 Pharmacist referral criteria were based on HbA1c result together with or without prior diagnosis of diabetes. On reflection, a high BGL result (more than 10 mmol/L for more than 24 h) could also trigger a referral for endocrine review, as it currently does for medical teams.…”