J Korean Diabetes.  2012 Sep;13(3):148-151.

Effective Education Strategies for Women with Gestational Diabetes Mellitus

Affiliations
  • 1Department of Nursing, Cheil General Hospital & Women's Healthcare Center, Kwandong University, Seoul, Korea. parkje33@paran.com

Abstract

Stress management is a very effective educational strategy for women with gestational diabetes mellitus (GDM). The long-term goal for women with GDM is prevention of diabetes in both mothers and their offspring. Thus, when we teach the women with GDM, we must emphasize continuous lifestyle modification and regular monitoring of blood glucose during the postpartum period. In obese women with GDM who maintain normoglycemia, the optimal gestational weight gain for a favorable pregnancy outcome is about 3 kg, much less than that given by the guidelines of the Institute of Medicine. Hemoglobin A1c (HbA1c) can potentially identify women who are have a high risk for adverse outcomes associated with GDM, including macrosomia and postpartum glucose intolerance. Until delivery, it is important that HbA1c levels are maintained below 6.0%, but ideally should be less than or equal to 5.5%.

Keyword

Gestational diabetes; Stress; Obesity; Weight gain; Glycosylated hemoglobin A

MeSH Terms

Blood Glucose
Diabetes, Gestational
Female
Glucose Intolerance
Hemoglobin A, Glycosylated
Hemoglobins
Humans
Institute of Medicine (U.S.)
Life Style
Mothers
Obesity
Postpartum Period
Pregnancy
Pregnancy Outcome
Weight Gain
Blood Glucose
Hemoglobin A, Glycosylated
Hemoglobins

Reference

1. Metzger BE. Summary and recommendations of the Third International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes. 1991. 40:Suppl 2. 197–201.
Article
2. Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva A, Hod M, Kitzmiler JL, Lowe LP, McIntyre HD, Oats JJ, Omori Y, Schmidt MI. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010. 33:676–682.
Article
3. Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, Hod M, Kitzmiller JL, Kjos SL, Oats JN, Pettitt DJ, Sacks DA, Zoupas C. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007. 30:Suppl 2. S251–S260.
Article
4. Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. 2009. Washington, DC: National Academies Press.
5. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson S. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001. 25:1175–1182.
Article
6. Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol. 1998. 91:97–102.
Article
7. Jensen DM, Damm P, Sørensen B, Mølsted-Pedersen L, Westergaard JG, Klebe J, Beck-Nielsen H. Clinical impact of mild carbohydrate intolerance in pregnancy: a study of 2904 nondiabetic Danish women with risk factors for gestational diabetes mellitus. Am J Obstet Gynecol. 2001. 185:413–419.
Article
8. Park JE, Park S, Daily JW, Kim SH. Low gestational weight gain improves infant and maternal pregnancy outcomes in overweight and obese Korean women with gestational diabetes mellitus. Gynecol Endocrinol. 2011. 27:775–781.
Article
9. Katon J, Williams MA, Reiber G, Miller E. Antepartum A1C, maternal diabetes outcomes, and selected offspring outcomes: an epidemiological review. Paediatr Perinat Epidemiol. 2011. 25:265–276.
Article
10. Mosca A, Paleari R, Dalfrà MG, Di Cianni G, Cuccuru I, Pellegrini G, Malloggi L, Bonomo M, Granata S, Ceriotti F, Castiglioni MT, Songini M, Tocco G, Masin M, Plebani M, Lapolla A. Reference intervals for hemoglobin A1c in pregnant women: data from an Italian multicenter study. Clin Chem. 2006. 52:1138–1143.
Article
11. Parretti E, Mecacci F, Papini M, Cioni R, Carignani L, Mignosa M, La Torre P, Mello G. Third-trimester maternal glucose levels from diurnal profiles in nondiabetic pregnancies: correlation with sonographic parameters of fetal growth. Diabetes Care. 2001. 24:1319–1323.
Article
12. Yogev Y, Ben-Haroush A, Chen R, Rosenn B, Hod M, Langer O. Diurnal glycemic profile in obese and normal weight nondiabetic pregnant women. Am J Obstet Gynecol. 2004. 191:949–953.
Article
13. Kim MY, Yang JH, Jang HC, Park JE, Yim CH, Chung HY, Han KO, Yoon HK, Han IK, Kim MJ, Han HK. Relationship between maternal weight gain and newborn's birthweight in women with normal glucose tolerance and gestational diabetes. Korean J Obstet Gynecol. 2001. 44:780–786.
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr