The role of social support on self-management of gestational diabetes mellitus

Objective: Little is known about the role of social support in facilitating positive health behaviors and care plan adherence among individuals with gestational diabetes mellitus (GDM). We aimed to understand individuals’ perceptions of the role of social support in their GDM management during pregnancy and the early postpartum period. Study Design: This is a secondary analysis of qualitative data collected during a feasibility randomized controlled trial of postpartum patient navigation for individuals with GDM. Participants completed in‐depth, semi‐structured interviews at 4‐12 weeks postpartum. Interviews addressed participants’ understanding of and experiences with GDM as well as facilitators and barriers to managing GDM. Data were analyzed using the constant comparative method. Results: Of 35 participants with transcripts available for analysis, half (56%) had a family member or friend with a history of either GDM or type 2 diabetes. Four themes regarding social support were identified: (1) the role of communal support (i.e., that which helped individuals feel less isolated), (2) indirect GDM support (removing logistical or other barriers so participants can focus on care), (3) direct GDM support (direct help with medical care, or health behavior change), and (4) limitations of social support (Table). Communal support subthemes encompassed communal lifestyle changes, advice, emotional support, and the role of support groups, which were particularly utilized by those with no family history of diabetes. Indirect support included transportation, child care, and work accommodations. Direct support included providing healthy food, giving shots, or providing accountability or motivation. Finally, participants acknowledged limited knowledge of GDM, stigma, and excessive concern as limitations of social support related to GDM. Conclusion: Harnessing the value of a pregnant patient’s social support network may be a key strategy to improve diet, exercise, and medical care plan adherence. Future work should further investigate how to capitalize on this resource through educational or other interventions. [Formula presented]