LAUSR

Background Pregnant women with pre-existing type 2 diabetes mellitus (T2DM) are at risk for poor maternal and neonatal health outcomes. Previous systematic reviews in pregnant women with T2DM have focused on physical activity, blood glucose monitoring, and insulin injections. Objective The purpose of this scoping review was to examine the barriers and facilitators to diabetes self-management in pregnant women with pre-existing type 2 diabetes mellitus. Method PubMed, CINAHL, and EMBASE databases were searched using the PRISMA-ScR guidelines. Inclusion criteria included manuscripts written in English and qualitative studies. Consensus statements were excluded. A metasummary was used to identify patterns in barriers and facilitators across studies. A vote-counting method was used to summarize qualitative findings. Results A total of ten qualitative publications was selected. This review suggests four themes describing barriers, included barriers of diabetes self-management in pregnancy, stress related to pregnancy with diabetes, a barrier to access to health care, and sensing a loss of control. The fifth theme described facilitators of diabetes self-management in pregnancy. Conclusion This supports an integrative model of maternity care and culturally relevant practices to overcome critical barriers and optimize key facilitators to enhance diabetes self-management behaviors and improve maternal and neonatal health outcomes.