This included regret and not making lifestyle changes earlier,56 symptoms of the LTC such as physical restrictions caused by shortness of breath,47 stress of making lifestyle changes,41 anxiety around tests such as checking blood sugar,36 and taking medication, in particular insulin.59 For women with diabetes in pregnancy, distress stemmed from the stress of health consequences for the participant, their baby, and managing a busy schedule of multiple clinic appointments and regular testing . Here, INS is linked to diabetes mellitus.