Diabetes stigma and discrimination are negative social judgements, stereotypes, prejudices and unfair treatment due to diabetes. A new study examines the impact of this stigma on women with GDM, writes ZOE DELEUIL.
To address diabetes stigma – a global health priority – we first need to understand it. Dr Elizabeth Holmes-Truscott, Deputy Director of the Australian Centre for Behavioural Research in Diabetes (ACBRD), a partnership between Diabetes Victoria and Deakin University, recently led a study exploring stigma among women with gestational diabetes (GDM).
Dr Holmes-Truscott was diagnosed with GDM during her own pregnancy and has first-hand experience of the blame and shame surrounding the condition.
GDM affects one in six pregnant women in Australia every year, and can result in high birth weight, pre-term birth and even stillbirth. Women with GDM are more likely to experience C-section delivery and are at elevated risk of high blood pressure, pre-eclampsia and future type 2 diabetes. Importantly, there’s also a significant emotional toll reported by women with GDM. Yet comparatively little research has explored diabetes stigma experienced by these women.
Study participants were women with current or recent GDM. They reported persistent stereotypes, including the incorrect assumption that GDM was caused by an unhealthy diet, higher body weight or physical inactivity, and that those with the condition are to blame.
Comments around diet, activity levels and body shape or size came from family members, colleagues and the wider community, with health professionals also identified as a primary source of stigma.
Some women reported that the stigma had an impact on their social and emotional wellbeing and led to them not disclosing their GDM to friends, family and colleagues, creating further isolation. Women also reported guilt, sadness, shame and disappointment in themselves and their pregnancy experience, along with ongoing health anxiety.
Within the clinical setting, some women reported being told what to do, lacking credibility due to their diagnosis or labelled ‘hard work’ if they queried health professionals’ advice or decisions. This can have a knock-on effect, with women disengaging from care.
Following diagnosis, the study found that scare tactics and fear-based messaging, frequently relating to the size and health of the unborn baby, were commonly used in maternal health care to motivate women to engage in intensive glucose management. These tactics can have the reverse effect, leading some women to fear using insulin to manage if it is needed, or not monitoring and reporting blood glucose levels.
Women also experienced limited and inflexible birthing options following diagnosis, with health professionals talking about adverse or even fatal outcomes for the unborn child should women question or not follow their recommendations.
Further, the study identified GDM stigma as a potential barrier to post-partum type 2 diabetes screening and family planning. The impacts of stigma during GDM can have long-term impacts.
“The experience of stigma can put emotional well-being, physical health and engagement in self-care all at risk,” says Dr Holmes-Truscott.
What do women with GDM need from those around them?
Physical and emotional support from family and friends helped women to feel accepted and protected against internalisation of stigma, which is when people start to believe the negative stereotypes or judgements about themselves.
Peers who had ‘been through it before’ offered real-life experiences of realistic GDM management and expectations, however this peer support sometimes led to the sharing of inaccurate information.
Furthermore, some health professionals were helpful breaking down misconceptions and addressing internalised stigma by providing accurate information and reassurance.
Transparent and collaborative care, including informed decision-making and flexible options, was highlighted as supporting emotional health, optimism and engagement in GDM management.
Some women discussed self-belief as important for limiting internalised stigma. They described feeling proud of their efforts, instead of engaging in self-blame, which helped them to stay positive and advocate for autonomy.
Participants also highlighted that education and access to non-stigmatising informational resources could support more accurate beliefs surrounding GDM risk factors, contributing to self-compassion and therefore lower levels of internalised stigma.
Furthermore, to reduce social stigma, women reported the need for greater education around the complex risk factors for GDM and suggested that mainstream and social media could present opportunities to raise community awareness.
“Our research provides a clear picture of the experiences and impacts of stigma among women with gestational diabetes in Australia,” says Dr Holmes-Truscott. “With this important foundation, now we can move towards developing ways to better support women with this very common condition of pregnancy.”
The new research lays the groundwork for the world’s first Global End Diabetes Stigma Summit, to be held in Jaipur, India, in March 2026. Co-led by Dr Holmes-Truscott, the Summit will bring together up to 300 people living with diabetes, advocates, leaders, and innovators from around the world who are dedicated to ending diabetes stigma and transforming the way diabetes is understood and discussed globally.
Do you have any questions about gestational diabetes?
The GDM Telehealth clinic is free to all pregnant women living in rural or remote WA who have recently been diagnosed with gestational diabetes and are looking for support.
We take referrals from obstetric services we regularly collaborate with, or alternatively, you can self-refer via our telehealth service by calling the Diabetes WA Helpline on 1300 001 880.
We also see women with gestational diabetes at our metro clinics for face-to-face appointments, and anyone living in Western Australia with questions about all types of diabetes can call our free helpline on 1300 001 880.
If you’ve had gestational diabetes, you can also register for the free online Baby Steps program.
