Strategies for the Management of Gestational Diabetes Mellitus From the Perspective of Stakeholders: A Systematic Review and Meta-Synthesis Publisher



Safavi Ardabili N ; Rafi A ; Hasannezhad M ; Aghapour E ; Neshati A ; Abdi F
Source: Journal of Diabetes and Metabolic Disorders Published:2026

Abstract

Background: Gestational diabetes mellitus (GDM) is prevalent during pregnancy. While clinical guidelines exist, implementation challenges persist due to limited understanding of stakeholder perspectives, including those of women with GDM, their families, and healthcare providers (HCPs). The aim of this study was to synthesize qualitative evidence on stakeholder experiences, barriers, facilitators, and strategies for effective GDM management. Methods: A systematic review and thematic meta-synthesis was conducted following PRISMA and ENTREQ guidelines. Databases (MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science) and gray literature were searched from their inception to August 31, 2025. Eligibility was defined using the SPIDER framework, focusing on qualitative studies exploring GDM management perspectives. Studies were appraised using the CASP checklist. Data were extracted systematically, and synthesized thematically using NVivo software, following the Thomas and Harden’s approach. The review was registered with PROSPERO (CRD420251161631). Results: From 1,500 + screened records, 48 studies were included, involving diverse global populations. Four overarching themes emerged: (1) Patient-Centered Education and Support, emphasizing tailored information, emotional support, and motivation to address knowledge gaps and stigma; (2) Collaborative Care and Family Involvement, highlighting interdisciplinary coordination, partner engagement, and community networks; (3) Practical Lifestyle and Self-Management Strategies, focusing on dietary adjustments, physical activity, self-monitoring, and postpartum care continuity; and (4) Systemic and Technological Innovations, advocating for improved care delivery, digital tools, and equity to mitigate barriers. A conceptual model integrates these themes into a holistic framework for GDM care. Conclusions: This synthesis underscores the need for patient-centered, culturally sensitive strategies integrating individual, interpersonal, and systemic elements to enhance GDM management. Findings can inform clinical practice, policy development, and future interventions to improve maternal and neonatal outcomes and prevent long-term complications like type 2 diabetes. Trial registration: Not applicable. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.