“I was tired of all the sticking and poking”: Identifying barriers to diabetes self- care among low- income pregnant women

Objective. Diabetes in pregnancy is a significant problem for low- income, minor - ity women. We sought to evaluate barriers to diabetes self- care during pregnancy in an underserved population. Methods. Twenty- nine in-depth, semi- structured interviews were performed over 10 women's pregnancies to identify barriers to successful diabetes man- agement, using cognitive load theory to frame interview questions. Qualitative analysis of interview data used grounded theory techniques. Results. Fifty percent of this cohort of minority, low- income, public aid- supported women had pregestational diabetes. Six barrier domains were identified: diabetes novelty; social and economic chaos; nutrition challenges; psychological stressors; burden of disease management; and outcome expectation inability to promote behavior change. Conclusions. Low- income women face multiple barriers to successful diabetes self- care during pregnancy. Ability to achieve diabetes goals in pregnancy is influenced by several social, cognitive, and knowledge- based factors. Understanding this complex interplay of factors impacting diabetes management may help providers work with patients in achieving healthy pregnancies.