AUTHOR=Liang Yan , Liu Qingli , Sun Xiaoyun , Wang Yan 

TITLE=Why patients’ knowledge alone isn’t enough: examining behavioral and attitudinal gaps in gestational diabetes management among Chinese women

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1589416

DOI=10.3389/fpubh.2025.1589416

ISSN=2296-2565

ABSTRACT=BackgroundGestational diabetes mellitus (GDM) prevalence is rising in China, necessitating an understanding of knowledge, attitudes, and practices (KAP) among affected women to inform interventions.MethodsThis cross-sectional study (June 2020–June 2024) surveyed 3,426 Chinese women with GDM, aged 20–60 years, from urban and rural prenatal clinics across Qingdao city, China. A validated 25-item KAP questionnaire used a three-option response format (yes, no, maybe). Data were collected via WeChat in urban areas and paper-based surveys in rural regions (89% response rate), analyzed using chi-square tests and binary logistic regression.ResultsSignificant KAP gaps emerged: 63% recognized GDM’s link to complications, but only 50% understood its comprehensive management, with 38% aware of eye exams and 40% of foot care needs. Practice adherence was poor—36% monitored blood glucose, 38% limited alcohol, and 53% practiced foot care, despite 59% adhering to medications. Attitudinally, 64% believed health-focused behavior drives management, yet only 36% viewed personal accountability as key, with 39% feeling providers understood their concerns. Intriguingly, younger women (20–30 years) were more open to education (OR 2.67, 95% CI 1.94–3.69, p < 0.001), while illiteracy (OR 88.7, 95% CI 34.7–249, p < 0.001) and older age (51–60 years: OR 12.7, 95% CI 8.79–18.4, p < 0.001) predicted poor outcomes. Positive attitudes were protective (OR 0.19, 95% CI 0.15–0.24, p < 0.001).ConclusionThese findings reveal entrenched KAP barriers in GDM management, underscoring the need for innovative, equity-driven interventions—integrating accessible education, community empowerment, and digital tools—to enhance outcomes and reduce the GDM burden in China.