A longitudinal qualitative study on the experiences and needs of women with gestational diabetes regarding blood glucose management using a journey map.

INTRODUCTION

Gestational diabetes mellitus (GDM) is a common pregnancy-related metabolic disorder that increases risks of adverse maternal and fetal outcomes, as well as long-term type 2 diabetes. Effective glycemic management requires addressing women's dynamic experiences and needs across pregnancy and the postpartum period. However, current evidence lacks longitudinal insights into patients' real-world experiences and unmet needs in glycemic self-management. This study aimed to explore the longitudinal experiences and needs of women with GDM regarding blood glucose management using a patient journey mapping approach, to inform person-centered care models and improve self-management outcomes.

METHODS

A longitudinal qualitative design was conducted. Eighteen women with GDM were recruited from a tertiary hospital in Xinxiang, China, between September 2025 and March 2026. Semi-structured interviews were performed at three time points: diagnosis (24-28 weeks' gestation), antenatal follow-up (3 months post-diagnosis), and postpartum follow-up (6 months post-diagnosis). Data were analyzed using qualitative content analysis, and a patient journey map was constructed covering tasks, pain points, and emotional dimensions.

RESULTS

Nineteen themes and subthemes emerged across three phases. During the diagnostic phase, women experienced emotional distress, knowledge gaps, and lifestyle adaptation difficulties. In the antenatal phase, self-management behaviors became internalized, accompanied by persistent vigilance, fatigue, and declining social support. Postpartum, women faced self-management burnout, role conflicts, and challenges in long-term glycemic control. The journey map visually depicted dynamic changes in emotions, tasks, and pain points throughout the continuum.

DISCUSSION: Glycemic management in GDM is phased and long-term, characterized by evolving experiences and needs. A tiered, nurse-led healthcare system integrating family support and "Internet+" technologies is recommended to deliver stage-specific interventions. Strengthening multi-source support and self-efficacy may reduce burnout and promote sustained self-management. These findings provide evidence for optimizing comprehensive care pathways for women with GDM.