Overview: New guidelines and the lived reality of GDM
Australia’s new national consensus on gestational diabetes (GDM) screening and diagnosis, led by the Australasian Diabetes in Pregnancy Society (ADIPS), aims for greater international consistency. But beyond thresholds and testing, women’s voices point to persistent gaps in psychosocial support, risk communication, and stigma reduction. A growing body of Australian qualitative studies shows that while clearer diagnostic criteria can reduce misdiagnosis and fear, the emotional burden and social perceptions surrounding GDM remain pressing concerns that influence care engagement and self-management.
The emotional toll of GDM
One recurring message from women with lived experience is that the mental health costs of GDM can eclipse the tangible health benefits of monitoring glucose. Qualitative accounts describe pregnancies that felt stripped of enjoyment, with little formal support for managing anxiety, stress, or guilt. The updated guidelines acknowledge GDM’s emotional impact and the lurking stigma, yet there is a gap in structured psychosocial screening and formal training for healthcare professionals to address these needs within routine care.
Screening and diagnosis: moving toward consistency
Many Australian women report inconsistent diagnostic thresholds across clinics before the update, creating confusion and sometimes unfair self-blame if a diagnosis was missed in one setting but not another. The new consensus moves toward higher thresholds and better international alignment, reducing unnecessary labelling and the associated emotional toll. However, changes can be unsettling for those diagnosed under previous criteria. The key is sensitive, clear communication that validates patients’ experiences while explaining the shift in thresholds.
Beyond thresholds: personalised, person-centred care
GDM is most common in certain risk groups—older age, higher body weight, family history, or specific ethnic backgrounds—but it can arise in anyone. The updated guidance promotes risk-informed screening and a holistic, individualized approach to care. It supports placing women in appropriate maternity models of care based on nuanced risk stratification. Yet the portrayal of some women as “high-risk” can feel dehumanising if not paired with respectful communication and shared decision-making. The guidelines should emphasize patient autonomy and empathetic discussions about what risk means for each person’s pregnancy journey.
Diabetes stigma: recognizing and reducing harm
A recurring theme in women’s stories is the stigma that accompanies a GDM diagnosis—feelings of judgment, blame, and a sense that one’s credibility is questioned. While the new guidance acknowledges stigma’s harms, concrete, actionable strategies to counter stigma are less evident. Stigma can discourage engagement with care and even affect post-pregnancy behaviors, including follow-up testing and future family planning. Actionable steps—such as clinician training on stigma-free communication and the adoption of patient-centered language—are essential to translate recognition into real change.
<h2 Toward stigma-free, compassionate care
Global and local efforts stress that evidence-based care must be delivered in a stigma-free environment. Initiatives like the Pledge to End Diabetes Stigma and empathic healthcare training offer routes to action. In the Australian context, incorporating lived-experience resources—such as storytelling tools and patient-reported experience measures—can help clinicians better understand GDM’s impact and tailor support. The goal is not just to diagnose accurately but to care in a way that honors women’s dignity, confidence, and choice.
Conclusion: balancing clarity with support
The updated ADIPS guidelines align with women’s preferences for clearer diagnostic thresholds and risk-informed screening, while recognizing the psychosocial and stigma-related challenges that accompany GDM. To truly meet community needs, future iterations should explicitly integrate structured psychosocial screening, actionable anti-stigma strategies in clinical practice, and robust patient education that supports informed, compassionate care during pregnancy and beyond. This patient-centered approach can improve not only pregnancy experiences but also long-term health outcomes for women with a history of GDM.
