Attitude and confidence in managing pre-existing type 2 diabetes mellitus during pregnancy among Thai women

Background: The trend of rising T2DM prevalence is more pronounced in females and is of particular concern for pregnancy. The rate has jumped from 0.7% to 1.5% of all pregnancies over the past 14 years. Additionally, pregnancies affected by T2DM have higher rates of abortion and perinatal mortality compared to those with type 1 diabetes mellitus and gestational diabetes mellitus. The objective of the study was to explore the attitudes and confidence in managing T2DM among Thai women during pregnancy. Methods: This qualitative study was a part of a parent study using a convergent parallel mixed-methods design. A purposive sampling was used. Inclusion criteria included pregnant women aged 20 to 44 years, diagnosed with T2DM, and able to communicate in Thai. A total of 12 Thai pregnant women with T2DM, with an average age of about 34 years old, and whose pregnancies spanned from 7 to 38 weeks of gestation. Directed content analysis was used for qualitative data analysis. Results: Twelve interviews were completed. Four main themes were identified: 1) attitudes toward diabetes self-management, 2) confidence toward diabetes self-management in pregnancy, 3) varied paths to pregnancy: planned vs. unplanned conception, and 4) navigating adjustments of diabetes self-management in pregnancy. Conclusion: The study highlights the importance of enhancing preconception care and tailoring diabetes management guidance to align with cultural contexts. Supporting pregnant women with diabetes requires a comprehensive approach that incorporates behavioral, sociocultural, and systemic healthcare considerations. Keywords: Attitude, Confidence, Pregnant Women, Type 2 Diabetes Mellitus