Gestational Diabetes

Gestational Diabetes Mellitus (GDM)

Concept Based Learning Activity (CBLA)

Nursing Implications / Family Centered Care

During pregnancy

Diet and physical activity. Insulin

Post-partum

- mum: follow-up glucose test 6 weeks to 6 months weeks after baby is born

Family Centered Care

Mutual respect

Teamwork

Communication and patient education

Support

Initial thoughts

Sources: HealthLink British Columbia (2023),

https://www.diabetes.ca/about-diabetes/gestational

What is Gestational Diabetes Mellitus (GDM)?

- GDM is diabetes diagnosed for the first time during pregnancy (2. or 3. trimester)

- Most often blood sugar levels return to normal soon after delivery.

- Diagnosis threshold is discussed worldwide.

Causation with obesity.

Sources: Mussa et al. (2021), Videncenter for Diabetes (2022), World Health Organisation (2013), Christiansen (2023),

Final thoughts

Questions

GDM effect and screening

How do you think GDM effects individuals who are already stuggling on a socioeconomic level?

How do we as students support a patients who has had GDM during their pregnancy?

Screening for GDM:

Diabetes Canada recommends testing

- at week 24-28 of pregnancy

- additionally, high risk pt should be tested at first prenatal visit

GDM causes increased risks of..:

- LGA

- Polyhydramnios (=large amounts of amniotic fluid). This can cause premature labour.

- Premature birth

- Pre-eclampsia

- Low blood-sugar in baby

- Jaundice (=yellowing of the skin and eyes)

- Stillbirth (rare)

Sources: National Health Service (2022), Berger et al. (2019), HealthLink British Columbia (2023)

References

Signs and symptoms

- Mussa, J., Meltzer, S., Bond, R., Garfield, N., Dasgupta, K. (2021). Trends in National Canadian Guideline Recommendations for the Screening and Diagnosis of Gestational Diabetes Mellitus over the Years: A Scoping Review. International Journal of Environmental Research and Public Health, 18(4), 1454.

- Videncenter for Diabetes. (2022, January 11). Hvad er graviditetsdiabetes? https://videncenterfordiabetes.dk/viden-om-diabetes/graviditetsdiabetes/hvad-er-graviditetsdiabetes

- National Health Service. (2022, December 8). Gestational Diabetes. https://www.nhs.uk/conditions/gestational-diabetes/

- Berger, H., Gagnon, R., Sermer, M. (2019). Guideline No. 393-Diabetes in Pregnancy: Abstract. Journal of Obstetrics and Gynaecology Canada, 41(12), p. 1814-1825.

- HealthLink British Columbia. (2023, March 1). Screening for Gestational Diabetes. https://www.healthlinkbc.ca/health-topics/screening-gestational-diabetes

- Lende M, Rijhsinghani A. (2020). Gestational Diabetes: Overview with Emphasis on Medical Management. International Journal of Environmental Research and Public Health, 17(24), 9573.

- World Health Organisation (WHO). (2013). Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy. WHO Publication.

- Christiansen, M. (2023, August 25). Diabetes I graviditeten. Patienthåndbogen. https://www.sundhed.dk/borger/patienthaandbogen/graviditet/sygdomme-og-komplikationer/graviditet-og-sygdom/diabetes-i-graviditeten/

- increased thirst

- increased voiding

- a dry mouth

Source: National Health Service (2022)

- tiredness

- blurred eyesight

- genital itching or thrush

Risk factors

- Previous LGA baby or pregnancy with GDM

- Family history of diabetes

- Advanced maternal age (>40 years)

- High BMI (>30)

- Origin: south Asian, Black, African-Caribbean or Middle Eastern.

- Previous significant weightloss

Sources: National Health Service (2022), Lende et al. (2020)