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Obstacles and Enablers Related to Gestational Diabetes Self-Management: Systematic Review Using the Socio-Eecological
Bronya H K Luk1, Polly H X Ma1, Rosenna Wai Ming Chung1
1School of Nursing and Health Sciences, Hong Kong Metropolitan University, Homantin, Hong Kong, 00852, China (Hong Kong), 852 3970 2975, 852 24062375.
JMIR Diabetes
|June 1, 2026
Summary
Effective gestational diabetes mellitus (GDM) self-management requires addressing multilevel factors. This review identifies key obstacles and enablers across the socioecological model to inform holistic support strategies for improved maternal and neonatal outcomes.
Area of Science:
- Public Health
- Maternal Health
- Health Behavior
Background:
- Gestational diabetes mellitus (GDM) necessitates effective self-management to reduce health risks.
- Understanding multilevel factors influencing adherence is crucial for developing holistic support strategies.
Purpose of the Study:
- To systematically review obstacles and enablers of GDM self-management.
- To analyze these factors across all five levels of the socioecological model (SEM).
Main Methods:
- Systematic literature search across six databases (2010-2025).
- Inclusion of 30 studies (qualitative, quantitative, mixed methods).
- Data synthesis using the SEM framework.
Main Results:
- Identified 11 key factors across intrapersonal, interpersonal, organizational, community, and policy levels.
- Revealed interactions creating systemic challenges like fragmented support and information inequity.
- Highlighted the influence of factors such as knowledge, social support, healthcare access, food environment, and policy.
Conclusions:
- Integrated, multilevel strategies are essential for successful GDM self-management support.
- An evidence-based SEM framework can guide the development of comprehensive interventions.
- Digital health platforms can be leveraged to improve maternal and neonatal outcomes.
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