Korean J Community Nutr.  2017 Jun;22(3):207-217. 10.5720/kjcn.2017.22.3.207.

Needs for Development of IT-based Nutritional Management Program for Women with Gestational Diabetes Mellitus

• Han CJ
• Lim SY
• Oh E
• Choi YH
• Yoon KH
• Lee JH

• KMID: 2386554
• DOI: http://doi.org/10.5720/kjcn.2017.22.3.207

Abstract

OBJECTIVES
The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM).
METHODS
A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3.
RESULTS
About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were "˜internet (50.0%)' and "˜expert advice (45.0%)'. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as "˜the cause of ketosis', "˜the goal of nutrition management for GDM', "˜the importance of sugar restriction on breakfast'. The major obstructive factors in dietary management were "˜eating more than planned when dining out', "˜finding the appropriate menu when dining out'. The preferred nutrition information contents in developing management program were "˜nutritional information of food', "˜recommended food by major nutrients', "˜the relationship between blood glucose and food', "˜tips on menu selection at eating out'. The subjects reported that they need management program such as "˜example of menu by calorie prescription', "˜recommended weight gain guide', "˜meal recording and dietary assessment', "˜expert recommendation', "˜sharing know-how'.
CONCLUSIONS
Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life.

Keyword

gestational diabetes mellitus (GDM); needs assessment; IT-based nutritional management program

MeSH Terms

Blood Glucose
Diabetes, Gestational*
Eating
Education
Exercise Therapy
Female
Food Habits
Humans
Needs Assessment
Nutritional Status
Pregnancy
Self Care
Seoul
Tertiary Care Centers
Weight Gain
Blood Glucose

Reference

1. Metzger BE. Summary and recommendations of the third international workshop-conference on gestational diabetes mellitus. Diabetes. 1991; 40(Suppl 2):197–201.

2. Paek YC, Oh MJ. Update in management of gestational diabetes mellitus. Korean J Perinatol. 2009; 20(1):6–16.

3. Jang HC. Gestational diabetes in Korea: incidence and risk factors of diabetes in women with previous gestational diabetes. Diabetes Metab J. 2011; 35(1):1–7.

4. Jang H, Jung K, Cho N, Metzger B. Gestational diabetes mellitus in Korea: is universal screening necessary? Korean J Obstet Gynecol. 1996; 39(39):519–530.

5. Jang HC, Cho YM, Park KS, Kim SY, Lee HK, Kim MY. Pregnancy outcome in Korean women with gestational diabetes mellitus diagnosed by the Carpenter-Coustan criteria. J Korean Diabetes Assoc. 2004; 28(2):122–130.

6. Koo YJ, Ryu HM, Yang JH, Lim JH, Lee JE, Kim MY. Pregnancy outcomes according to increasing maternal age. Taiwan J Obstet Gynecol. 2012; 51(1):60–65.

7. Di Cianni G, Volpe L, Lencioni C, Miccoli R, Cuccuru I, Ghio A. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res Clin Pract. 2003; 62(2):131–137.

8. Korean Diabetes Association. 2015 Treatment Guidelines for Diabetes. 1st ed. Seoul: Goldgihoek;2015. p. 31–37.

9. Franz MJ, Bantle J, Beebe C, Brunzell J, Chiasson J, Garg A. Nutrition principles and recommendations in diabetes. Diabetes care. 2004; 27(Suppl 1):S36–S46.

10. Gunderson EP. Gestational diabetes and nutritional recommendations. Curr Diabetes Rep. 2004; 4(5):377–386.

11. Petry CJ. Gestational diabetes: risk factors and recent advances in its genetics and treatment. Br J Nutr. 2010; 104(6):775–787.

12. Choi ES, Oh JA, Hur MH, Lee IS, Choi SY. The knowledge and learning needs about gestational diabetes in pregnant women. J Korean Acad Womens Health Nurs. 2000; 6(1):96–108.

13. Park JE. Effective education strategies for women with gestational diabetes mellitus. J Korean Diabetes. 2012; 13(3):148–151.

14. Daniells S, Grenyer BF, Davis WS, Coleman KJ, Burgess JAP, Moses RG. Gestational diabetes mellitus. Diabetes care. 2003; 26(2):385–389.

15. Hjelm K, Berntorp K, Frid A, Åberg A, Apelqvist J. Beliefs about health and illness in women managed for gestational diabetes in two organisations. Midwifery. 2008; 24(2):168–182.

16. Kim H. Development and evaluation of an integrated selfmanagement program for women with gestational diabetes mellitus. J Korean Soc Matern Child Health. 2013; 17(1):1–14.

17. Park SY, Yang YJ, Kim Y. Effects of nutrition education using a ubiquitous healthcare (u-Health) service on metabolic syndrome in male workers. Korean J Nutr. 2011; 44(3):231–242.

18. Nes AA, van Dulmen S, Eide E, Finset A, Kristjánsdóttir ÓB, Steen IS. The development and feasibility of a web-based intervention with diaries and situational feedback via smartphone to support self-management in patients with diabetes type 2. Diabetes Res Clin Pract. 2012; 97(3):385–393.

19. Han JS, Jeong JH. A web-based internet program for nutritional counseling and diet management of patient with diabetes mellitus. J Korean Soc Food Sci Nutr. 2004; 33(1):114–122.

20. Park SY, Han JS. Effects of web-based nutrition counseling on dietary behavior and food intake of type II diabetic patients. J Korean Soc Food Sci Nutr. 2006; 35(4):430–439.

21. Kim YJ, Rhee SY, Byun JK, Park SY, Hong SM, Chin SO. A smartphone application significantly improved diabetes selfcare activities with high user satisfaction. Diabetes Metab J. 2015; 39(3):207–217.

22. Park SY. A study on the correlation between diabetes patients' knowledge, self-care behavior and the educational demand [master's thesis]. Sahmyook University;2012.

23. Ahn Y, Bae J, Youn JE, Kim HS. Needs assessment for webbased self-management program by the nutrition knowledge levels of diabetic patients. Korean J Community Nutr. 2011; 16(1):155–168.

24. Choi KI. The relationships between knowledge of diabetes, barrier and compliance with sick role behavior of diabetic patients [master's thesis]. Ewha Womans University;2010.

25. Gastrich MD, Peck S, Janevic T, Bachmann G, Lotwala N, Siyam A. Gestational diabetes mellitus: An educational opportunity. J Diabetes Nurs. 2013; 17(6):220–224.

26. Jun JE. A study on barriers and problem solving related to dietary therapy in diabetics mellitus patients [master's thesis]. Kyungwon University;2008.

27. Ko JM, Lee JK. Effects of a coaching program on comprehensive lifestyle modification for women with gestational diabetes mellitus. J Korean Acad Nurs. 2014; 44(6):672–681.

28. Lim HS, Chyun JH, Kim YS, Nam MS. Effect of nutrition education on diabetic management in diabetic patients. Korean J Nutr. 2001; 34(1):69–78.

29. Park OJ. Effect of individual patient teaching through home visiting on compliance with sick role behavior in diabetic patients and duration of the effect of the teaching. J Nurs Acad Soc. 1990; 20(2):174–184.

30. Kim JH, Chang SA. Effect of diabetes education program on glycemic control and self management for patients with type 2 diabetes mellitus. Korean Diabetes J. 2009; 33(6):518–525.

31. Bi Y, Zhu D, Cheng J, Zhu Y, Xu N, Cui S. The status of glycemic control: a cross-sectional study of outpatients with type 2 diabetes mellitus across primary, secondary, and tertiary hospitals in the Jiangsu province of China. Clin Ther. 2010; 32(5):973–983.

32. Lim DJ, Kwon HS, Kim HS, Lee JH, Ko SH, Lee JM. Clinical characteristics of the diabetic patients managed at the different medical institutions in Seoul and Gyeonggi province. Korean J Med. 2006; 71(2):173–181.