title: Gestational diabetes mellitus in Tonga: insights from healthcare professionals and women who experienced gestational diabetes mellitus.
abstract: OBJECTIVE
  To gain contextual insights from Tongan healthcare professionals and women who had developed gestational diabetes mellitus (GDM).
  
  
  METHODS
  Qualitative, individual, semi-structured, face-to-face interviews were conducted during 2006 with 11 women who had developed GDM in the previous 12 months and 10 health professionals who worked in the GDM/diabetes area in Tonga.
  
  
  RESULTS
  Due to funding issues glucose supplies were often scarce which precluded universal screening. GDM management which focused on encouraging behavioural change to diet and physical activity were reported to be effective in managing GDM in Tonga. Changes to physical activity levels were difficult because of 'laziness' (the participant's words). Preventative screening was perceived to be a foreign idea in Tonga which negatively influenced post-partum screening and monitoring.
  
  
  CONCLUSIONS
  GDM was reportedly well-managed through lifestyle interventions. `Laziness', identified as a contributing factor to obesity and physical inactivity needs to be considered within a broader context of complex social and economic changes in Tonga. There are clear challenges to shift attitudes towards preventative screening in Tonga and for screening supplies to be adequately funded. Lifestyle intervention targeted towards modifiable risk factors of obesity and physical activity for GDM and Type 2 diabetes need to extend into the postpartum period.
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Lismore, NSW 2480, Australia. frances.doran@scu.edu.au
authors.forename: Frances
authors.initials: F
authors.lastname: Doran
authors.forename: Kierrynn
authors.initials: K
authors.lastname: Davis
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D011247:Pregnancy; D014058:Tonga / Q000453:epidemiology