“If I Don’t Eat Enough, I Won’t Be Healthy”. Women’s Experiences with Gestational Diabetes Mellitus Treatment in Rural and Urban South India

Karoline Kragelund Nielsen, Thilde Vildekilde, Anil Kapur, Peter Damm, Veerasamy Seshiah and Ib C. Bygbjerg
Additional contact information
Karoline Kragelund Nielsen: Diabetes Prevention, Health Promotion Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
Thilde Vildekilde: Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Copenhagen, Denmark
Anil Kapur: World Diabetes Foundation, Krogshoejvej 30A, 2820 Bagsvaerd, Denmark
Peter Damm: Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
Veerasamy Seshiah: Dr. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, 729 Poonamallee High Road, Aminjikarai, Chennai, Tamil Nadu 600029, India
Ib C. Bygbjerg: Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Copenhagen, Denmark

IJERPH, 2020, vol. 17, issue 9, 1-19

Abstract: Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%–35% of pregnant women develop GDM. In this study, we investigated women’s experiences with the dietary and pharmaceutical treatment for GDM in rural and urban Tamil Nadu, India. Semi-structured interviews were conducted with 19 women diagnosed with GDM. Data were analyzed using qualitative content analysis. Three overall aspects were discovered with several sub-aspects characterizing women’s experiences: emotional challenges (fear and apprehension for the baby’ health and struggling to accept a treatment seen as counterintuitive to being safe and healthy), interpersonal challenges (managing treatment in the near social relations and social support, and coordinating treatment with work and social life), and health system-related challenges (availability and cost of treatment, interaction with health care providers). Some aspects acted as barriers. However, social support and positive, high-quality interactions with health care providers could mitigate some of these barriers and facilitate the treatment process. Greater efforts at awareness creation in the social environment and systemic adjustments in care delivery targeting the individual, family, community and health system levels are needed in order to ensure that women with GDM have the opportunity to access treatment and are enabled and motivated to follow it as well.

Keywords: gestational diabetes mellitus; India; treatment; access to health care; qualitative research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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