Self-care interventions among women with gestational diabetes mellitus in low and middle-income countries: a scoping review

BACKGROUND: Gestational diabetes mellitus (GDM) is a transitory form of diabetes occurring in pregnancy with maternal and neonatal health consequences if left untreated. GDM can, in most instances, be managed non-medically through self-care practices, such as eating healthy or engaging in physical activity. This is especially relevant in a global health context with scarce resources. There is no official definition of "GDM self-care"; hence, the content and delivery modes of such interventions may vary greatly. Therefore, this study aimed to landscape GDM self-care interventions in low- and middle-income countries according to the WHO's three dimensions of health.

METHODS: PubMed, Embase, Global Health Library, and Web of Science were searched for published intervention studies that compared the effect of a self-care intervention to standard care or had no comparator. Studies that targeted women with GDM that reported maternal health and/or neonatal health outcomes (physical, mental, and social health outcomes) and were conducted in low- and middle-income countries were included in the review.

RESULTS: Twenty-nine studies (randomised controlled trials and non-randomised studies) were included in the review. No studies were conducted in low-income countries, and studies were primarily conducted in Asia. Most interventions were complex and contained several interacting elements in relation to content, delivery mode, duration, and modality. Most interventions aimed to improve the physical health dimension (n = 28; 96.6%), whilst the mental health (n = 11; 37.9%) and social health dimensions (n = 9; 31.0%) were addressed to a lesser extent.

CONCLUSIONS: Current GDM self-care interventions in LMICs are complex, and the content of self-care interventions overlaps with lifestyle and non-pharmaceutical interventions. It is recommended that the scientific community use a standardised terminology for such interventions and that future GDM intervention studies, as a minimum, use the core outcome set for GDM when developing future studies.

SYSTEMATIC REVIEW REGISTRATION: OSF Registries (2 December 2022) [ https://doi.org/10.17605/OSF.IO/PJZQ3 ].