{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:13:17Z","timestamp":1781118797270,"version":"3.54.1"},"reference-count":28,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"UC Davis Richard A. and Nora Eccles Harrison Diabetes Research Award"},{"name":"Kaiser Permanente Center for Upstream Prevention of Adiposity and Diabetes Mellitus"},{"name":"Kaiser Permanente Northern California Division of Research Health Equity Research Supplement","award":["R01DK122087"],"award-info":[{"award-number":["R01DK122087"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K26DK138246"],"award-info":[{"award-number":["K26DK138246"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK092924"],"award-info":[{"award-number":["P30DK092924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK122087"],"award-info":[{"award-number":["R01DK122087"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) increases risk for adverse health outcomes and disproportionately affects racial and ethnic minority populations. Achieving optimal glycemic control during pregnancy mitigates risks but requires consistent blood glucose monitoring, diet, physical activity, and, when needed, medication adherence. We sought to identify barriers and facilitators of GDM treatment adherence among racially and ethnically diverse patients with suboptimal glycemic control (&amp;lt;80% of glucose values\/week within goal) or monitoring (&amp;lt;14 measurements\/week) in their most recent GDM-affected pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Using a convergent parallel mixed-methods design guided by the Capability, Opportunity, Motivation\u2013Behavior framework, we collected quantitative data using validated online survey tools and conducted racially concordant virtual focus groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Forty participants (25% Asian, 18% Black, 20% Hispanic, 23% White, 15% multiracial) completed surveys; 28 joined focus groups. Self-reported adherence was 55% for glucose monitoring, 70% for diet, and 45% for physical activity. Among those prescribed medication (n = 26), 85% reported taking it as prescribed, with higher adherence for insulin (90%) than oral agents (67%). Barriers included unsupportive workplaces, discomfort with fingersticks, limited time for activity, and frustration when goals were unmet despite perceived adherence. Although 85% reported food security, participants wanted greater nutritional support from family and community. Preferences for holistic and less invasive management, including continuous glucose monitors, were expressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Patients with suboptimal glycemic control or monitoring reported barriers such as workplace constraints, limited nutritional resources, and invasive treatments. Patient-centered education, community support, and expanded treatment options may improve adherence and outcomes in diverse populations with GDM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc25-0034","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T16:06:57Z","timestamp":1776442017000},"page":"385-395","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Patient Perspectives on Glycemic Control: A\u00a0Mixed-Methods Study of Diverse Patients With Gestational\u00a0Diabetes Mellitus"],"prefix":"10.2337","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2239-2561","authenticated-orcid":false,"given":"Bridgette P.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of California 1 , Davis, Sacramento, CA"},{"name":"UC Davis Center for Women\u2019s Heart and Brain Health, University of California 2 , Davis, Sacramento, CA"},{"name":"Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California 3 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Regional Perinatal Service Center, Kaiser Permanente Northern California 4 , Santa Clara, CA"},{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Scandurro","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Serrato-Bandera","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Millman","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siedah","family":"Garrison","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California 1 , Davis, Sacramento, CA"},{"name":"UC Davis Center for Women\u2019s Heart and Brain Health, University of California 2 , Davis, Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Haynes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California 6 , Davis, Sacramento, CA"},{"name":"Center for Health and Technology, UC Davis Health 7 , Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeyi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California 3 , Pleasanton, CA"},{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assiamira","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California 3 , Pleasanton, CA"},{"name":"Division of Research, Kaiser Permanente Northern California 5 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California 1 , Davis, Sacramento, CA"},{"name":"UC Davis Center for Women\u2019s Heart and Brain Health, University of California 2 , Davis, Sacramento, CA"},{"name":"Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California 3 , Pleasanton, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"2026061014530545600_B1","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.15585\/mmwr.mm6743a2","article-title":"Prevalence and changes in preexisting diabetes and gestational diabetes among women who had a live birth - 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