Background: Hyperglycemia in pregnancy is associated with adverse pregnancy outcomes. Strict glycaemic control is necessary to promote favourable pregnancy outcomes.

Objectives: To assess adherence to anti-diabetic therapy (diet, physical activity and medications) in women with diabetes in pregnancy.

Methods: This study utilized a cohort of 157 pregnant women at three Central hospitals in Zimbabwe. Adherence to anti-diabetic therapy was the exposure and the outcomes of interest were maternal and perinatal outcomes. This paper focuses on adherence levels. Consecutive sampling was used to recruit women with diagnoses of gestational diabetes, type 1 and type II diabetes. Ethical approval was granted by respective ethical review boards. Participants gave informed consent. Data was collected through an interviewer administered questionnaire which had sections on demographics, adherence to diet, physical activity and medications and perinatal outcomes. An adherence level of at least 80%, measured by self-report, was high while an adherence of less than 80% was low. Data were analyzed using the statistical package for Social Sciences (SPSS) version 20. Descriptive statistics were used to analyze demographic data and adherence levels.

Results: Majority participants (31.8%) were aged from 30-34 years. Regarding type of diabetes, 25.5% had type I, 43.9% type II while 30.6% had gestational diabetes mellitus. Mean adherence to anti-diabetic therapy was 79.6%.

Conclusions: Adherence to anti-diabetic therapy namely diet, physical activity and medications was suboptimal. Adherence counselling and monitoring is essential in pregnancy considering the strict glycemic control that is required in diabetes in pregnancy.