Decision-making behavior of blood glucose management and its influencing factors in pregnant women with gestational diabetes mellitus.

Background: Currently, most studies only focus on the glucose management level and self- management behavior of pregnant women with gestational diabetes mellitus, but lack analysis and discussion on their decision-making behavior and influencing factors during glucose management.

Aim: This study aimed to investigate the decision-making behavior of blood glucose management and its influencing factors among pregnant women with gestational diabetes mellitus in China.

Methods: This was a prospective study. A convenience sampling method was used to select pregnant women with gestational diabetes mellitus. A total of 1,405 pregnant women with gestational diabetes mellitus from eight hospitals in China were included between June 1 and December 31, 2023. Three types of questionnaires on knowledge, protection motivation, and decision-making behavior regarding blood glucose management were administered to participants. Multivariable logistic regression was conducted to determine the decision-making behavior of blood glucose management and its influencing factors (P<0.05).

Results: The mean score of the glucose management knowledge was 39.56 ± 8.45 points (standard score 65.9%). The score for decision-making behavior was 70.05 ± 9.85 points (standard score 93.4%). Most dimensions of protection motivations were higher than 20 points (standard score 80.0%).

Conclusions: The mean score for glucose management knowledge was at a medium score level. Most dimensions of protection motivations were at a high or medium score level. The decision-making behavior was at a high score level. The pregnant women with rich glucose management knowledge and protection motivation are more likely to take active decision-making behaviors and actively manage their blood glucose levels. The influencing factors of decision-making behavior included length of time after diagnosed with gestational diabetes mellitus, gestational diabetes mellitus history, self-efficacy, severity, susceptibility, response efficacy, and response costs (P<0.05, for all).