Women’s Experiences, Perceptions, And Barriers To Insulin Therapy In Gestational Diabetes Mellitus: A Systematic Review

Abstract

Pregnant women very often suffer from gestational diabetes (GDM). In this condition, they are affected physiologically, psychologically and sociologically. These conditions lead them to different perceptions and experiences. Some barriers to insulin therapy can affect the effectiveness of treatment for GDM.

Much research and reviews have been conducted on this topic. This systematic literature review seeks to update our information on various aspects related to GDM.

Thus, this systematic literature review aimed to undertake a more detailed review and analysis of the experiences, perceptions and barriers to insulin therapy among pregnant women affected with GDM. For this purpose, papers were identified from Google Scholar using the PRISMA flow process to screen and select the most appropriate 25 papers.

The review showed that women with GDM undergo many positive and negative experiences and possess many positive and negative perceptions depending on the care context and the study methods. They also identified many barriers to insulin therapy. Most reviewed studies provided the practical implications of these observations and offered solutions to some of the vexing problems in this regard.

Objective: To explore the experiences, perceptions, and barriers to insulin therapy among pregnant women with gestational diabetes mellitus across diverse cultural and healthcare settings.

Methods: A systematic literature review was conducted by including qualitative, quantitative, and mixed-methods studies examining women's lived experiences, perceptions, and barriers related to insulin therapy in GDM. A literature search was conducted using Google Scholar following PRISMA guidelines, together with screening of reference lists of relevant papers.

Results: Twenty-five studies involving women with GDM across 13 countries contributed to this review. Our results indicated that women with GDM commonly experienced fear, emotional distress, and stigma following diagnosis and insulin initiation. Key barriers to insulin therapy included fear of injection, concerns about fetal harm, lack of awareness, work-related challenges, and insufficient healthcare support. Facilitators included trust in healthcare providers, family support, concern for fetal well-being, and access to education and digital health tools. Most reviewed studies provided practical implications and proposed solutions to improve women's engagement with insulin therapy.

Conclusion: Women with GDM face significant emotional, social, and informational barriers to insulin therapy. Addressing these barriers through person-centred care, culturally tailored education, and enhanced social support is essential to improving treatment adherence and pregnancy outcomes.