{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:23:07Z","timestamp":1783084987693,"version":"3.54.6"},"reference-count":53,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","award":["Project 562\/FR2\/ NIHR SPCR"],"award-info":[{"award-number":["Project 562\/FR2\/ NIHR SPCR"]}],"id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,6,2]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Optimal management of gestational diabetes mellitus (GDM) is essential to reduce risks for mother and child. Women with GDM have a tenfold higher risk of developing type 2 diabetes (T2D), particularly those from ethnically diverse or socioeconomically disadvantaged groups. This can be reduced through lifestyle change and annual screening but there is a paucity of data from the UK exploring engagement. Aims were to (1) explore GDM experiences among a diverse sample of UK women and (2) identify factors which could help women engage with GDM self-management guidance during pregnancy and with T2D risk prevention strategies postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited a diverse sample of South Asian, black African and white British women from the community and primary and secondary care settings to take part in an online or face-to-face interview. Community recruitment was prioritised to engage women who may not normally take part in research. Interviews were audio-recorded and transcribed. An inductive thematic content analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>35 women participated (66% from ethnically diverse groups; 43% first-generation immigrants). Engagement with GDM guidance was shaped by five themes: the psychological burden of diagnosis; challenges balancing everyday life with glucose monitoring and dietary changes; building resilience through personal strategies; healthcare relational support influencing confidence and adherence; and one-size-fits-all guidance being inadequate. Postpartum, women described being \u2018left at sea\u2019, reporting limited follow-up and unclear pathways for ongoing diabetes prevention and competing pressures of motherhood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Apps, online support groups, personally tailored lifestyle advice and empathetic online or face-to-face healthcare interactions supported GDM self-management. Postpartum knowledge about the risks and useful steps for diabetes prevention was low, and confusion was exacerbated by mixed messages from healthcare teams. Engagement was harder for women facing socioeconomic adversity and for those for whom cultural norms conflict with lifestyle guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003909","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:08:50Z","timestamp":1783084130000},"page":"e003909","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Engagement with gestational diabetes self-management: a qualitative study from the UK"],"prefix":"10.1136","volume":"4","author":[{"given":"Amanda P","family":"Moore","sequence":"first","affiliation":[{"name":"Research Department of Primary Care and Population Health, UCL Centre for Behaviour Change, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerys","family":"Astbury","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-123X","authenticated-orcid":false,"given":"Shoba","family":"Poduval","sequence":"additional","affiliation":[{"name":"Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Ross","sequence":"additional","affiliation":[{"name":"Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026070306002499000_4.3.e003909.1","doi-asserted-by":"crossref","DOI":"10.3390\/ijms19113342","article-title":"The Pathophysiology of Gestational Diabetes Mellitus","volume":"19","author":"Plows","year":"2018","journal-title":"Int J Mol Sci"},{"key":"2026070306002499000_4.3.e003909.2","doi-asserted-by":"publisher","DOI":"10.1007\/S11892-016-0727-5"},{"key":"2026070306002499000_4.3.e003909.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2021.101016","article-title":"A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations","volume":"38","author":"Delanerolle","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2026070306002499000_4.3.e003909.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2010.01140.x"},{"key":"2026070306002499000_4.3.e003909.5","doi-asserted-by":"publisher","DOI":"10.3310\/hta20220"},{"key":"2026070306002499000_4.3.e003909.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2015.04.006"},{"key":"2026070306002499000_4.3.e003909.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m1361","article-title":"Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis","volume":"369","author":"Vounzoulaki","year":"2020","journal-title":"BMJ"},{"key":"2026070306002499000_4.3.e003909.8","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/dme.13834","article-title":"Impact of maternal income on the risk of gestational diabetes mellitus in primiparous women","volume":"36","author":"R\u00f6n\u00f6","year":"2019","journal-title":"Diabet Med"},{"key":"2026070306002499000_4.3.e003909.9","unstructured":"National Institute for Health and Care Excellence (NICE) . DIabetes in pregnancy: Management from preconception to the postnatal period. NICE, 2015."},{"key":"2026070306002499000_4.3.e003909.10","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.03.06.dc05-1118"},{"key":"2026070306002499000_4.3.e003909.11","doi-asserted-by":"crossref","first-page":"E910","DOI":"10.1210\/jc.2014-3898","article-title":"The Diabetes Risk Phenotype of Young Women With Recent Gestational Diabetes","volume":"100","author":"Rottenkolber","year":"2015","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"key":"2026070306002499000_4.3.e003909.12","doi-asserted-by":"crossref","first-page":"3747","DOI":"10.1111\/dom.16400","article-title":"Pregnancy and postpartum cardiometabolic outcomes among women with overt diabetes compared to women with normoglycaemia, gestational diabetes and pre-existing diabetes: A systematic review and meta-analysis","volume":"27","author":"Pal","year":"2025","journal-title":"Diabetes Obes Metab"},{"key":"2026070306002499000_4.3.e003909.13","article-title":"Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews","volume":"8","author":"Martis","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2026070306002499000_4.3.e003909.14","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanepe.2022.100420","article-title":"Population level impact of the NHS Diabetes Prevention Programme on incidence of type 2 diabetes in England: An observational study","volume":"19","author":"McManus","year":"2022","journal-title":"Lancet Reg Health Eur"},{"key":"2026070306002499000_4.3.e003909.15","doi-asserted-by":"crossref","DOI":"10.1111\/1753-0407.13590","article-title":"The efficacy of interventions to prevent type 2 diabetes among women with recent gestational diabetes mellitus-A living systematic review and meta-analysis","volume":"16","author":"Lee","year":"2024","journal-title":"J Diabetes"},{"key":"2026070306002499000_4.3.e003909.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-022-04931-5","article-title":"A scoping review of gestational diabetes mellitus healthcare: experiences of care reported by pregnant women internationally","volume":"22","author":"Pham","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026070306002499000_4.3.e003909.17","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-2745-1"},{"key":"2026070306002499000_4.3.e003909.18","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s11154-020-09610-4","article-title":"The experiences of pregnant women with gestational diabetes mellitus: a systematic review of qualitative evidence","volume":"22","author":"He","year":"2021","journal-title":"Rev Endocr Metab Disord"},{"key":"2026070306002499000_4.3.e003909.19","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.wombi.2022.08.006","article-title":"The needs and experiences of women with gestational diabetes mellitus from minority ethnic backgrounds in high-income nations: A systematic integrative review","volume":"36","author":"Tzotzis","year":"2023","journal-title":"Women Birth"},{"key":"2026070306002499000_4.3.e003909.20","unstructured":"NIHR, Diabetes UK . UK strategy for clinical and applied diabetes research. 2023."},{"key":"2026070306002499000_4.3.e003909.21","unstructured":"Voices M-UKM . Saving lives, improving mother\u2019s care. Mothers and babies: Reducing risk through audits and confidential enquiries across the UK. MBRRACE-UK, 2022."},{"key":"2026070306002499000_4.3.e003909.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-015-0360-1","article-title":"Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach","volume":"13","author":"Greenhalgh","year":"2015","journal-title":"BMC Med"},{"key":"2026070306002499000_4.3.e003909.23","doi-asserted-by":"crossref","first-page":"e203","DOI":"10.1016\/j.wombi.2022.08.004","article-title":"Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review","volume":"36","author":"Lalor","year":"2023","journal-title":"Women Birth"},{"key":"2026070306002499000_4.3.e003909.24","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-018-1657-9","article-title":"Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study","volume":"18","author":"Parsons","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026070306002499000_4.3.e003909.25","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1434"},{"key":"2026070306002499000_4.3.e003909.26","doi-asserted-by":"crossref","first-page":"100171","DOI":"10.1016\/j.glmedi.2024.100171","article-title":"Sample size for saturation in qualitative research: Debates, definitions, and strategies","volume":"5","author":"Ahmed","year":"2025","journal-title":"Journal of Medicine, Surgery, and Public Health"},{"key":"2026070306002499000_4.3.e003909.27","first-page":"222","article-title":"Thematic analysis","volume":"3","author":"Clarke","year":"2015","journal-title":"Qualitative Psychology: A Practical Guide to Research Methods"},{"key":"2026070306002499000_4.3.e003909.28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2011.00646"},{"key":"2026070306002499000_4.3.e003909.29","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2402"},{"key":"2026070306002499000_4.3.e003909.30","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1368"},{"key":"2026070306002499000_4.3.e003909.31","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1177\/1932296820965577","article-title":"Application of Mobile Technology for Disease and Treatment Monitoring of Gestational Diabetes Mellitus Among Pregnant Women: A Systematic Review","volume":"16","author":"Garg","year":"2022","journal-title":"J Diabetes Sci Technol"},{"key":"2026070306002499000_4.3.e003909.32","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.midw.2016.06.019","article-title":"Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study","volume":"40","author":"Draffin","year":"2016","journal-title":"Midwifery"},{"key":"2026070306002499000_4.3.e003909.33","doi-asserted-by":"crossref","unstructured":"Haigh C , Lau HWR , Weir T , et al . The experiences of women from culturally and linguistically diverse backgrounds with gestational diabetes mellitus: A mixed methods systematic review. Endocrino Diabet & Metabol 2023;6. doi:10.1002\/edm2.421","DOI":"10.1002\/edm2.421"},{"key":"2026070306002499000_4.3.e003909.34","doi-asserted-by":"crossref","DOI":"10.2196\/39689","article-title":"Barriers to and Facilitators of Using eHealth to Support Gestational Diabetes Mellitus Self-management: Systematic Literature Review of Perceptions of Health Care Professionals and Women With Gestational Diabetes Mellitus","volume":"24","author":"Safiee","year":"2022","journal-title":"J Med Internet Res"},{"key":"2026070306002499000_4.3.e003909.35","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18062993","article-title":"Implementing Anti-Racism Interventions in Healthcare Settings: A Scoping Review","volume":"18","author":"Hassen","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026070306002499000_4.3.e003909.36","unstructured":"Esan O , Adjei N , Saberian S , et al . Mapping existing policy interventions to tackle ethnic health inequalities in maternal and neonatal health in England: A systematic review with stakeholder engagement. NHS Race and Health Observatory 2022."},{"key":"2026070306002499000_4.3.e003909.37","unstructured":"Charles A . Integrated care systems explained: making sense of systems, places and neighbourhoods.: the King\u2019s fund. 2022. Available: https:\/\/www.kingsfund.org.uk\/publications\/integrated-care-systems-explained [Accessed 3 Jul 2023]."},{"key":"2026070306002499000_4.3.e003909.38","doi-asserted-by":"crossref","DOI":"10.2196\/41855","article-title":"From Social Network to Peer Support Network: Opportunities to Explore Mechanisms of Online Peer Support for Mental Health","volume":"10","author":"Rayland","year":"2023","journal-title":"JMIR Ment Health"},{"key":"2026070306002499000_4.3.e003909.39","doi-asserted-by":"publisher","DOI":"10.1145\/3479865"},{"key":"2026070306002499000_4.3.e003909.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104454"},{"key":"2026070306002499000_4.3.e003909.41","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2188\/jea.JE20200079","article-title":"Online Peer Support and Well-being of Mothers and Children: Systematic Scoping Review","volume":"32","author":"Yamashita","year":"2022","journal-title":"J Epidemiol"},{"key":"2026070306002499000_4.3.e003909.42","first-page":"212","article-title":"A review: maximizing social support-a neglected strategy for improving weight management with African-American women","volume":"14","author":"Wolfe","year":"2004","journal-title":"Ethn Dis"},{"key":"2026070306002499000_4.3.e003909.43","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.337"},{"key":"2026070306002499000_4.3.e003909.44","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003646"},{"key":"2026070306002499000_4.3.e003909.45","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00592-023-02099-8","article-title":"Effectiveness of a comprehensive telemedicine intervention replacing standard care in gestational diabetes: a randomized controlled trial","volume":"60","author":"Munda","year":"2023","journal-title":"Acta Diabetol"},{"key":"2026070306002499000_4.3.e003909.46","doi-asserted-by":"publisher","DOI":"10.1177\/1049732314524636"},{"key":"2026070306002499000_4.3.e003909.47","unstructured":"NHS England . Language matters: Language and diabetes. NHS England, 2018."},{"key":"2026070306002499000_4.3.e003909.48","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-055329","article-title":"The effects of health behaviours and beliefs based on message framing among patients with chronic diseases: a systematic review","volume":"12","author":"Gao","year":"2022","journal-title":"BMJ Open"},{"key":"2026070306002499000_4.3.e003909.49","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2009.03.007"},{"key":"2026070306002499000_4.3.e003909.50","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/S2213-8587(17)30193-6","article-title":"Person-centred type 2 diabetes care: time for a paradigm shift","volume":"6","author":"Rutten","year":"2018","journal-title":"The Lancet Diabetes & Endocrinology"},{"key":"2026070306002499000_4.3.e003909.51","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15433"},{"key":"2026070306002499000_4.3.e003909.52","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.wombi.2014.09.002","article-title":"A review of interventions to prevent Type 2 Diabetes after Gestational Diabetes","volume":"27","author":"Peacock","year":"2014","journal-title":"Women Birth"},{"key":"2026070306002499000_4.3.e003909.53","doi-asserted-by":"crossref","first-page":"9","DOI":"10.15277\/bjd.2020.236","article-title":"Gestational diabetes: screening uptake, current challenges and the future \u2013 a focused review","volume":"20","author":"Vounzoulaki","year":"2020","journal-title":"Br J Diabetes"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:09:09Z","timestamp":1783084149000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":53,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2025-003909"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003909","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}