Elton, Caroline Sarah; (1997) Psychological aspects of pregnancy amongst women with insulin-dependent diabetes mellitus. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This study investigated emotional adjustment and regimen adherence of pregnant women with insulin-dependent diabetes mellitus (IDDM). 40 pregnant women with IDDM (P/D group), 35 pregnant non-diabetic women (P/N-D group) and 25 non-pregnant women who had IDDM (N-P/D group) were interviewed in their homes. Both of the diabetic groups self-monitored their regimen adherence in the week following the interview. All P/D and P/N-D interviews took place in the second trimester of pregnancy. Pregnancy was associated with significant shifts in blood glucose testing behaviour but only minor shifts in dietary behaviour. The two diabetic groups also differed in the factors that predicted blood glucose testing. Health beliefs and attitudes to the disease did not alter dramatically during pregnancy. The 2 pregnant groups did not differ in terms of physical symptoms of pregnancy or in rates of hospitalization. The P/D group did not report higher levels of health anxieties and they were optimistic about the prognosis for the pregnancy. No group differences were found in psychological attachment to the foetus. Within both pregnant groups attachment to the foetus was found to be unrelated to feelings about the state of pregnancy. The three groups did not differ in current levels of depressed mood but the N-P/D group had experienced a significantly higher rate of previous emotional problems. The generally favourable psychological adjustment of the P/D women was attributed to changes in the medical management of diabetic pregnancy and the improved prognosis for both mother and baby. The suggestion is also made that that the P/D women may have differed in their tolerance of physical symptoms of pregnancy. The limitations of the current study and suggestions for future research are discussed.

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