Stress and anxiety in women with gestational diabetes during dietary management

Diabetes Educ. 2014 Sep-Oct;40(5):668-77. doi: 10.1177/0145721714535991. Epub 2014 May 29.


Purpose: To explore the stress and anxiety experiences during dietary management in women with gestational diabetes (GDM).

Methods: Thirty women with GDM from the Winnipeg area participated in the mixed methods study. Each participant completed a Food Choice Map semistructured interview, a Perceived Stress Scale, a Pregnancy Anxiety Scale, a State-Trait Anxiety Inventory-Trait questionnaire, and a demographic questionnaire. Stress and anxiety experiences were identified from interview transcripts and categorized into themes based on the constant comparative method. Questionnaire scores aided in interpreting the stress and anxiety experience in the qualitative data.

Results: Three major themes were generated from the interviews: (1) stress related to GDM diagnosis and the perception of a high risk pregnancy; (2) stress over losing control of GDM during the process of dietary management; and (3) anxiety related to the fear of maternal and infant complications. Women on insulin experienced significantly higher levels of perceived stress (P < .01), and the dietary management stress was more prevalent in women using insulin compared to the ones on diet treatment only (Fisher exact test, P < .01). Unhealthy diet coping strategies occurred with the stress and anxiety.

Conclusions: Stress and anxiety were associated with different contexts in this study sample. Women who were on insulin experienced significantly higher levels of perceived stress related to dietary management.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety* / epidemiology
  • Canada / epidemiology
  • Choice Behavior*
  • Diabetes, Gestational / diet therapy
  • Diabetes, Gestational / drug therapy
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / psychology*
  • Diet, Diabetic*
  • Feeding Behavior
  • Female
  • Food Preferences
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Infant, Newborn
  • Insulin / administration & dosage
  • Pregnancy
  • Pregnant Women / psychology*
  • Prenatal Care
  • Qualitative Research
  • Self Report
  • Social Perception
  • Social Support
  • Stress, Psychological* / epidemiology
  • Stress, Psychological* / etiology


  • Hypoglycemic Agents
  • Insulin