Our latest research explores what helps, and what hinders, Indian and Chinese women in Australia from attending type 2 diabetes screening after gestational diabetes
By Dr Jo Jordan
Gestational diabetes (GDM) during pregnancy increases a woman’s risk of developing type 2 diabetes (T2D) later in life. After giving birth, regular T2D screening is recommended as early detection supports better health in the future. Australian guidelines recommend screening 6-12 weeks after childbirth and every 1-3 years thereafter. Yet, around half of women with prior GDM do not attend screening.
The ME-MaGDA study, led by Prof Jane Speight, aimed to understand why this might be and find ways to overcome barriers to screening. We’ve already shared findings from our literature review and initial interview study. Here, we focus on our new study led by collaborators at Monash University, exploring barriers to screening for women from Indian and Chinese backgrounds.
In Australia, women from Chinese and Indian backgrounds have higher rates of GDM compared with the general population. Yet they are also less likely to attend follow-up T2D screening after birth. We wanted to understand why — and what could help make screening easier for these women.
Ten women (six born in China and four born in India) who had GDM during pregnancy shared their stories. Researchers coded the interview transcripts using a model called the Theoretical Domains Framework. This framework helped to identify what changes could make it easier for these women to attend routine screening for T2D. Key findings are reported under specific Theoretical Domains Framework areas.
Knowledge is essential
It was important that women knew that GDM increased their risk for T2D after birth. This helped them to understand why screening matters for the future. They also needed to know how often they should attend T2D screening.
However, some didn’t know about their risk of T2D, or the need to screen.
“It was always painted to me like the gestational diabetes will go away when the baby is born. So then, if I pull through it … then it’s all going to be fine…” (participant ID01, Chinese born)
Social support or influences
Support from family or relatives was helpful in assisting women to be able to attend screening appointments. However not having this support also made it harder for women to take up screening.
“The first year… my mum and others can’t be here so it’s just myself I have to look after two kids…” (Participant ID20, Chinese born)
Screening was also more likely when healthcare professionals presented it as a normal and important part of postnatal care.
“I had my test for the GP, because… she also suggested to have the test and that’s pretty much it…” (Participant ID29, Indian born).
Emotion
Wanting to have another child and fear of developing T2D were motivators for women to attend screening. For some, the unknown future risk of developing T2D was a source of worry.
“I don’t know what the factors are that some people who do end up having diabetes permanently after gestational diabetes… I don’t know what determines that” (Participant ID08, Indian born)
What needs to change?
The study suggests small, practical changes can make a big difference.
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- Provide clear, culturally tailored information about GDM and T2D risk.
- Send reminders about follow-up screening.
- Make screening part of standard post-birth care.
- Encourage family support and involvement.
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With the right information, reminders, and support, more women from Chinese and Indian backgrounds in Australia can protect their health — and their families’ futures — after gestational diabetes.
Check out our other blogs on gestational diabetes and type 2 diabetes.
Reference:
Neven ACH, Lake AJ, Williams A, Licqurish S, Lim S, O’Reilly SL, Hendrieckx C, Morrison M, Dunbar JA, Speight J, Teede H, Boyle JA; ME-MaGDA study group. Barriers to and enablers of type 2 diabetes screening among Indian and Chinese women with prior gestational diabetes: A qualitative study applying the Theoretical Domains Framework. Midwifery. 2025 Jun;145:104370. doi: 10.1016/j.midw.2025.104370. Epub 2025 Mar 11. PMID: 40188742.
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