Gestational diabetes mellitus in Tonga: insights from healthcare professionals and women who experienced gestational diabetes mellitus
Frances, D & Davis, K 2010, 'Gestational diabetes mellitus in Tonga: insights from healthcare professionals and women who experienced gestational diabetes mellitus', New Zealand Medical Journal, vol. 123, no. 1326, pp. 59-67.
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Aim To gain contextual insights from Tongan healthcare professionals and women who had developed gestational diabetes mellitus (GDM).
Method Qualitative, individual, semi-structured, face-to-face interviews were conducted during 2006 with 11 women who had developed GDM in the previous 12 months and 10 health professionals who worked in the GDM/diabetes area in Tonga.
Results Due to funding issues glucose supplies were often scarce which precluded universal screening. GDM management which focused on encouraging behavioural change to diet and physical activity were reported to be effective in managing GDM in Tonga. Changes to physical activity levels were difficult because of ‘laziness’ (the participant’s words). Preventative screening was perceived to be a foreign idea in Tonga which negatively influenced post-partum screening and monitoring.
Conclusion GDM was reportedly well-managed through lifestyle interventions. `Laziness’, identified as a contributing factor to obesity and physical inactivity needs to be considered within a broader context of complex social and economic changes in Tonga. There are clear challenges to shift attitudes towards preventative screening in Tonga and for screening supplies to be adequately funded. Lifestyle intervention targeted towards modifiable risk factors of obesity and physical activity for GDM and Type 2 diabetes need to extend into the postpartum period.