A Study to Explore the Gaps in Gestational Diabetes Mellitus Management in a Selected Tertiary Healthcare Center – Mixed Method Design

Abstract Introduction: Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder diagnosed during pregnancy and typically resolves after childbirth. Ineffective management of GDM results in high-risk pregnancy and untoward complications for the woman and fetus. The treatment regimen includes pharmacological and nonpharmacological interventions. This study aimed to identify the gaps in adherence to nonpharmacological interventions (Phase I) and to understand the factors influencing nonpharmacological treatment adherence (Phase II) among women with GDM. Materials and Methods: Conducted at a tertiary healthcare center in Chengalpattu district, Chennai, Tamil Nadu, India, this study used purposive sampling to contact women diagnosed with GDM. Eighty consenting women were included in Phase I, while Phase II involved participants from Phase I, achieving data saturation after the 13 th participant. Results: Phase I: Findings revealed increased consumption of carbohydrates, less protein, fat, and fiber with <½ involved in physical activity. Phase II: The themes that emerged were (a) Food purchasing decisions: Influences on dietary choices, (b) Cooking menu choices: Decisions about meal preparation, (c) Deciding authority: Who influences dietary practices, (d) Family support systems: The impact of family support on adherence (e) Health beliefs and misconceptions: Misunderstandings about physical activity (f) Obstacles and recommendations: Barriers to effective management and suggested improvements. Conclusion: Adherence to GDM management is crucial for preventing complications. Involving spouses and significant family members in GDM education and management can enhance support for planning and implementing nonpharmacological interventions. Appointing clinical nurse specialists, a counselor, and a liaison officer at the hospital level, along with establishing a health promotion café, can enhance access to healthcare resources for women with GDM and improve overall management of the condition.