A pregnant woman sat on a park bench using a blood sugar testing kit.

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King's researchers tackling gestational diabetes stigma through co-designed multimedia interventions

09 June 2026

Health

For many women diagnosed with gestational diabetes (GDM), the condition brings not only medical risks but also a significant emotional burden. This is often driven by stigma surrounding the diagnosis, leading to feelings of guilt and shame. Researchers at King’s are creating films, animations and communication tools to challenge GDM stigma and reduce that burden.

Stigma is a negative judgement leading to exclusion, rejection or blame associated with something (such as diabetes). People living with diabetes can experience it in many forms, including from the public, partners, family members and even healthcare professionals. Stigma can also be internalised, leading to feelings of anxiety and self-blame, which negatively impact mental health.

Stigma can be particularly difficult for women with GDM. Alongside the physical and emotional changes of pregnancy, women are often subject to close monitoring of diet, exercise, weight, blood glucose and medication use. Although this monitoring is important for health, it can make women feel judged for a condition that is not caused by individual behaviour alone.

Women with GDM frequently blame themselves – “it’s my fault” – and worry they're harming their baby. This is often driven by the perception that GDM is a lifestyle-related condition – "people think I got this because I’m greedy and lazy."

Professor Angus Forbes and Dr Rita Forde lead the Multimedia messaging to reduce diabetes related stigma for women with gestational diabetes mellitus project, funded by Diabetes UK and supported by King's Better Health & Care Hub. It seeks to understand stigma experiences during and after GDM pregnancies and to work with women and healthcare professionals to create multimedia interventions that reduce its impact.

Where the project began

The project builds on earlier research. As Angus explains: "Previous studies had already revealed the significant psychological burden associated with GDM pregnancies. Again and again, stigma emerged as a key driver of that distress."

Stigma has long been associated with diabetes, particularly weight-related stigma, but it extends far beyond that.

People with diabetes are often made to feel as though they have failed, that they are ‘broken’. A message that surfaces repeatedly, and not only in GDM but also in type 2 diabetes, is the idea that this is a condition you have brought upon yourself, but that’s not accurate, there are many factors that increase the risk of GDM. GDM affects up to 1 in 10 pregnancies in women of all body sizes from different ethnicities.– Professor Angus Forbes, Professor or Diabetes Nursing

For Dr Judith Parsons, this became clear during her doctoral research. While her PhD interviews and focus groups were not initially designed to study stigma, women’s accounts repeatedly returned to feelings of blame and judgement.

“Many women believed their diagnosis was their fault, sometimes because of their own internal narratives, but often because of comments from others, media messages or interactions with healthcare professionals,” Judith explains.

She recalls that weight-related stigma featured heavily in women’s experiences of care. “Crucially, the emotional effects did not end when pregnancy did. For some women, what they experienced during pregnancy stayed with them long afterwards, becoming a lasting source of distress or trauma.”

Funding from Diabetes UK provided the opportunity to address these issues directly, not simply by documenting stigma, but by finding ways to challenge it.

How stigma shapes care

GDM is typically diagnosed around the end of the first trimester, at approximately 12 weeks. For many women, Angus explains, this marks a sudden disruption to what they expected pregnancy to be: “From that point on, their care becomes more intensive: regular blood glucose testing, dietary guidance and lifestyle advice designed to keep sugar levels within a safe range.”

This monitoring is important for medical reasons. High blood sugar levels can affect how a baby grows, increasing the likelihood of babies being larger than expected for their stage of pregnancy. This can raise the risk of complications such as caesarean sections, admission to neonatal intensive care and birth trauma, including shoulder dystocia. However, for many women, this level of monitoring can feel judgemental, contributing to feelings of self-blame and guilt.

Alongside the physical risks associated with GDM, there are broader and less visible consequences for both mother and baby. In this context, stigma begins to shape how women experience and engage with their care.

When women feel judged, they may begin to distance themselves emotionally from healthcare encounters, even while continuing to attend appointments.– Dr Judith Parsons, Lecturer and Researcher in Women's Health in Long-Term Conditions

The mental health impact

While stigma may influence how women engage with care, its most profound effects are often psychological. Research shows high levels of anxiety and depression associated with GDM, both during pregnancy and after birth. Recent survey findings from the team suggest that these psychological effects can continue even after the pregnancy ends.

Addressing stigma, Angus believes, could help break this cycle – not only by improving engagement with care, but by reducing long-term emotional harm.

How this study will help to reduce stigma

Rita, Angus, Judith and their colleagues have been working with a multidisciplinary team including linguists, clinicians and women with experience of GDM, to co-design resources and anti-stigma messages. These include an animation that shares women’s experiences and helps challenge stigma through content aimed at women, health professionals, friends, family and wider society. It explains that GDM is very common and results from normal changes in the body during pregnancy, emphasising that it's not caused by personal choices or lifestyle, that any woman can develop GDM, and that it's not the woman’s fault.

The study has also produced a series of short video interviews in which women share their stories of GDM and provide messages to help reduce stigma.

A woman with experience of GDM smiling during an interview, sitting in front of a plant.

I think when it comes to gestational diabetes, it's quite a stressful time within your pregnancy and you already have a lot of anxiety and you're probably judging yourself a lot about how you have managed to get to this position. So I think the important thing to say to yourself is I'm doing the best I can, this isn't my fault and just shut out the noise from other people outside.– Emma, speaking in a short video interview

In addition, the study will provide conversational tools and alternative destigmatising language that health professionals can use to support better communication with women with GDM. Together, it’s hoped these resources will reduce the stigma experienced by women with GDM and support a reduction in internalised stigma.