{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:57:16Z","timestamp":1785571036332,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100030906","name":"Bangladesh Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030906","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although clinical guideline of gestational diabetes mellitus (GDM) is well\u2010defined, still influence of the household environment and caregiver support on patient's adherence to self\u2010management remains under\u2010explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify the patient, household, and caregiver\u2010level determinants of GDM self\u2010management in Dhaka, Bangladesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study was conducted among 251 dyads of GDM patients including their caregivers across four tertiary hospitals in Dhaka. Diabetes self\u2010management (DSM) was evaluated using the validated Diabetes Self\u2010Management Questionnaire (DSMQ) (Cronbach's alpha\u2009=\u20090.74), supplemented by a pretested, semi\u2010structured instrument assessing caregiver knowledge and support. Predictors of suboptimal DSM were identified using multivariable logistic regression with backward elimination in STATA. Model discrimination was validated using the area under the receiver operating characteristic curve (AUC\u2010ROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Suboptimal DSM was observed in 68.5% of participants. Domain\u2010specific analysis revealed critical gaps in glycemic monitoring (82.5%), dietary control (75.7%), and physical activity (73.3%), while healthcare utilization (56.2%) showed higher adherence. Multivariable modeling demonstrated that household architecture was a dominant predictor; living in nuclear or extended families significantly increased the odds of suboptimal DSM compared to living alone. Further determinants included clinical complexity (comorbidities, family history) and reproductive history (parity \u22652). Notably, caregiver\u2010level factors, specifically poor knowledge and inadequate support (prevalent in &gt;50% of caregivers), were robustly associated with deficient glycemic monitoring and healthcare utilization (AUC\u2009=\u20090.78).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest that the household unit, rather than the individual patient, is the functional unit of GDM care. Transitioning toward family\u2010centered therapeutic models is essential to improve maternal and neonatal outcomes in GDM cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70347","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:29:49Z","timestamp":1780324189000},"page":"1409-1418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self\u2010management in gestational diabetes mellitus in Bangladesh: Determinants from women and caregivers' perspectives employed a cross\u2010sectional study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9040-7386","authenticated-orcid":false,"given":"Bilkis","family":"Banu","sequence":"first","affiliation":[{"name":"Department of Public Health Independent University, Bangladesh (IUB)  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2199-5353","authenticated-orcid":false,"given":"Nasrin","family":"Akter","sequence":"additional","affiliation":[{"name":"Department of NHMRC Clinical Trials Center, Faculty of Medicine and Health University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Jiaur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Health Science, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moomtahina","family":"Fatima","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation The Michael E. DeBakey Department of Surgery, Baylor College of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatema","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Smart Healthcare and Research Ltd  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2604-9649","authenticated-orcid":false,"given":"Md Nazmul","family":"Karim","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00825-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-025-06510-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.25259\/IJMR_1874_2025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S015"},{"key":"e_1_2_11_6_1","article-title":"Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta\u2010analysis","volume":"369","author":"Vounzoulaki E","year":"2020","journal-title":"BMJ"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00827-4"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1430"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003606"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2024.104141"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14061274"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0369"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2023.102766"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274978"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065063"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2025-084159"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267243"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00432-1"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3329\/jssmc.v10i2.41167"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2023.07.003"},{"key":"e_1_2_11_21_1","unstructured":"DGHS.Bangladesh Health Facility Registry (BHFR). 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