Prevalence of anxiety among gestational diabetes mellitus patients: A systematic review and meta-analysis

National, state and territory trends in gestational diabetes mellitus in Australia, 2016-2021: Differences by state/territory and country of birth

OBJECTIVE

To examine trends of gestational diabetes mellitus (GDM) in Australia by state/territory and country of birth.

METHODS

A cross-sectional study was undertaken from 2016 to 2021 using data from the National Diabetes Services Scheme (NDSS) and Australian Bureau of Statistics. The trends were assessed using Average Annual Percentage Changes (AAPCs) and the Cochrane-Armitage test.

RESULTS

Nationally, the age-standardised incidence of GDM was 9.3% (95%CI; 9.1-9.4) in 2016 and 15.7% (95%CI; 15.4-15.9) in 2021, representing AAPC of +10.9%. The highest increase was in the Northern Territory, from 6.7% (95%CI; 5.1-8.3) in 2016 to 19.2% (95%CI; 16.9-21.6) in 2021, AAPC=+24.6%. In Southeast Asian-born women, the incidence of GDM rose from 12.2% (95%CI; 11.7-12.7) in 2016 to 22.5% (95%CI; 21.9-23.2) in 2021 (p-trend<0.001).

CONCLUSIONS

The incidence of GDM has risen in Australia, particularly in the Northern Territory and Victoria, as well as among those born in Southeast Asia and South and Central Asia.

IMPLICATIONS FOR PUBLIC HEALTH

This increase in GDM incidence in Australia underscores the pressing need for location and culturally responsive GDM prevention interventions. The lack of information on some risk factors of GDM (e.g. high body mass index) in the NDSS registry requires further investigation.

Experiences of stigma, psychological distress, and facilitative coping among pregnant people with gestational diabetes mellitus

BACKGROUND

Gestational diabetes mellitus (GDM) has been rising in the United States, and it poses significant health risks to pregnant individuals and their infants. Prior research has shown that individuals with GDM also experience prevalent stress and mental health issues, which can further contribute to glucose regulation difficulties. Stigma associated with GDM may contribute to these mental health challenges, yet there is a lack of focused research on GDM-related stigma, its impact on psychological health, and effective coping mechanisms. Thus, this qualitative study aims to understand individuals' experiences related to GDM stigma, mental health, and facilitative coping.

METHODS

In-depth, semi-structured interviews were conducted with 14 individuals with a current or recent (within the last year) diagnosis of GDM. Thematic analysis was employed to guide data analysis.

RESULTS

Four themes emerged from data analysis: (1) experience of distal GDM stigma including stigmatizing provider interactions, stigma from non-medical spaces, and intersecting stigma with weight, (2) internalized GDM stigma, such as shame, guilt, and self-blame, (3) psychological distress, which included experiences of stress and overwhelm, excessive worry and fear, and loneliness and isolation, and (4) facilitative coping mechanisms, which included diagnosis acceptance, internet-based GDM community, active participation in GDM management, social and familial support, and time for oneself.

CONCLUSIONS

Findings demonstrate the relevance of GDM stigma in mental health among people with GDM and the need for addressing GDM stigma and psychological health in this population. Interventions that can reduce GDM stigma, improve psychological wellness, and enhance positive coping may facilitate successful GDM management and healthy birth outcomes. Future quantitative, theory-driven research is needed to understand the prevalence of GDM stigma experiences and mechanisms identified in the current study, as well as among marginalized populations (e.g., individuals of color, sexual and gender minorities).

The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes

Background

The aim of this study was to understand how physical activity and sedentary behaviour levels of pregnant women with gestational diabetes in the UK have been affected by COVID-19.

Methods

An online survey exploring physical activity and sedentary behaviour levels of pregnant women with gestational diabetes during COVID-19 was distributed through social media platforms. Women who had been pregnant during the COVID-19 outbreak and had gestational diabetes, were resident in the UK, were 18 years old or over and could understand written English were invited to take part.

Results

A total of 724 women accessed the survey, 553 of these met the eligibility criteria and took part in the survey. Sedentary time increased for 79% of the women during the pandemic. Almost half of the women (47%) were meeting the physical activity guidelines pre COVID-19 during their pregnancy, this dropped to 23% during the COVID-19 pandemic. Fear of leaving the house due to COVID-19 was the most commonly reported reason for the decline. Significant associations were found between meeting the physical activity guidelines during COVID-19 and educational attainment, fitness equipment ownership and knowledge of how to exercise safely in pregnancy.

Conclusions and implications

These results show the impact of COVID-19 on physical activity and sedentary behaviour levels and highlight the need for targeted public health initiatives as the pandemic continues and for future lockdowns. Women with gestational diabetes need to know how it is safe and beneficial to them to engage in physical activity and ways to do this from their homes if fear of leaving the house due to COVID-19 is a barrier for them. Online physical activity classes provided by certified trainers in physical activity for pregnant women may help them remain active when face-to-face appointments are reduced and limited additional resources are available.

The Effect of Solution-Oriented Counseling on Coping Strategies in Mental Health Issues in Women with Gestational Diabetes

This study aimed to investigate the effectiveness of solution-oriented intervention in patients with gestational diabetes, stress and anxiety on using coping strategies. This study was a randomized clinical trial with a control group. The population consisted of 56 diabetic women under treatment with insulin, who obtained higher score in one of the psychological disorders using DASS-21 (Depression, anxiety, stress scale). The participants were randomly assigned in two interventional (n = 28) and control (n = 28) groups after signing the written informed consent forms. The solution-oriented interventional program was conducted in six 60-min sessions for 6 weeks. Immediately after the final session and 6-8 weeks after the first session of the intervention, both groups completed coping inventory for stressful situations. The analytical statistic of t-test, chi-square, and variance analysis with repeated measurements using SPSS were used to analyze the data. solution-oriented counseling increased the problem-solving coping strategy in the intervention group (P = 0.001); the scores obtained by the subjects in the interventional group after adjusting the score before the intervention increased 2.68 units immediately after the intervention, which was not statistically significant (p-value = 0.44). However, it increased 11.5 scores six weeks after the intervention, which was statistically significant (P = 0.00). But, emotional and avoidance coping strategies were not significantly different between the two groups. This technique can be easily trained to all clients, and since it is focused on finding various solutions for psychological problems by clients, it can be used to reduce stress and anxiety in other chronic diseases as well.IRCT code: The code of this clinical trial study is IRCT20200202046339N1.

Associations between Gestational Diabetes and Anxiety or Depression: A Systematic Review

Gestational diabetes mellitus (GDM) pregnant women are under more psychological stress than normal pregnant women. With the deepening of the study of gestational diabetes mellitus, research has shown that anxiety and depression are also an important cause of gestational diabetes mellitus. Anxiety and depression can cause imbalances in the hormone levels in the body, which has a serious impact on the pregnancy outcome and blood glucose control of pregnant women with GDM. Therefore, the main purpose of this paper is to provide a systematic review of the association between anxiety, depression, and GDM, as well as the adverse effects on pregnant women with GDM. To this end, we searched the PubMed, CNKI, Embase, Cochrane Library, Wanfang, and Weipu databases. Studies on the incidence of anxiety, depression, and GDM, blood glucose in pregnant women with GDM, delivery mode, and maternal and infant outcomes were included to be analyzed, and the source of anxiety and depression in pregnant women with GDM and related treatment measures were discussed.

Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

OBJECTIVE

We assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM.

METHODS

From July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24-28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes.

RESULTS

A total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors.

CONCLUSION

The present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.