Background: Glycaemic target recommendations vary widely between international professional organisations for
women with gestational diabetes mellitus (GDM). Some studies have reported women’s experiences of having GDM,
but little is known how this relates to their glycaemic targets. The aim of this study was to identify enablers and
barriers for women with GDM to achieve optimal glycaemic control.
Methods: Women with GDM were recruited from two large, geographically different, hospitals in New Zealand to
participate in a semi-structured interview to explore their views and experiences focusing on enablers and barriers to
achieving optimal glycaemic control. Final thematic analysis was performed using the Theoretical Domains Framework.
Results: Sixty women participated in the study. Women reported a shift from their initial negative response to accepting
their diagnosis but disliked the constant focus on numbers. Enablers and barriers were categorised into ten domains
across the three study questions. Enablers included: the ability to attend group teaching sessions with family and hear
from women who have had GDM; easy access to a diabetes dietitian with diet recommendations tailored to a woman’s
context including ethnic food and financial considerations; free capillary blood glucose (CBG) monitoring equipment,
health shuttles to take women to appointments; child care when attending clinic appointments; and being taught CBG
testing by a community pharmacist. Barriers included: lack of health information, teaching sessions, consultations, and
food diaries in a woman’s first language; long waiting times at clinic appointments; seeing a different health professional
every clinic visit; inconsistent advice; no tailored physical activities assessments; not knowing where to access appropriate
information on the internet; unsupportive partners, families, and workplaces; and unavailability of social media or support
groups for women with GDM. Perceived judgement by others led some women only to share their GDM diagnosis with
their partners. This created social isolation.
Conclusion: Women with GDM report multiple enablers and barriers to achieving optimal glycaemic control. The
findings of this study may assist health professionals and diabetes in pregnancy services to improve their care for
women with GDM and support them to achieve optimal glycaemic control.