Improving outcomes by effective communication with would-be mothers with gestational diabetes at tertiary care center
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20242818Keywords:
GDM, MNT, Diabetes in pregnancy, Education counselling, Nutritional counsellingAbstract
Background: Gestational diabetes mellitus (GDM) is a metabolic disorder characterized by carbohydrate intolerance detected for the first-time during pregnancy. It may result in various complications in both the mother and child. The purpose of this study was to assess their knowledge about diabetes, doubts about safe pregnancy and misconceptions regarding treatment. It helped us in creating awareness amongst patients, their caregivers and of fellow doctors involved in patient care.
Methods: Each patient was started on a treatment protocol and compliance of medical nutrition therapy (MNT) in patients and calorie requirement were recorded. They were counselled regarding the care they need to execute and provided sample diet chart modified according to their needs, as per the guidelines laid down by ministry of health and family welfare, government of India 2018.
Results: Majority of the GDM women were obese (65%). Majority of the patients had calorie requirement of 2080 (37.50%) followed by 1750 (25%) and 2580 (22.50%). The compliance of MNT in present study was 68.33%.
Conclusions: Patients were unaware about diabetes, had fear for their unborn child, of a safe pregnancy and delivery. Patients were educated about gestational diabetes, its consequences, and how we can together prevent them. The guidelines for gestational diabetes care and assessment during ANC checkup has to be inculcated at grass root level. Patients, their care takers, nursing staff, doctors have to be involved as a team in providing care and implementing these guidelines.
References
Choudhury AA, Rajeswari VD. Gestational diabetes mellitus-A metabolic and reproductive disorder. Biomed Pharmacotherapy. 2021;143:112-83.
Fadl H, Magnuson A, Östlund I, Montgomery S, Hanson U, Schwarcz E. Gestational diabetes mellitus and later cardiovascular disease: a Swedish population based case-control study. BJOG. 2014;121(12):1530-6.
Anjana RM, Sudha V, Lakshmipriya N, Anitha C, Unnikrishnan R, Bhavadharini B, et al. Physical activity patterns and gestational diabetes outcomes-The wings project. Diabetes Res Clin Pract. 2016;116:253-62.
Koivusalo SB, Rönö K, Klemetti MM, Roine RP, Lindström J, Erkkola M, et al. Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): A Randomized Controlled Trial. Diabetes Care. 2016;39(1):24-30.
Ministry of Health and family Welfare. Maternal Health Division. Diagnosis and Management of Gestational Diabetes Mellitus. Technical and Operational Guidelines. 2018;1-100.
Winning strategies to address diabetes in pregnancy. An antenatal care approach. Available at: https://www.jhpiego.org/wp-content/uploads/2018/03/GDMPhotobook_Low-resolution.pdf. Accessed on 5 February 2024.
Morampudi S, Balasubramanian G, Gowda A, Zomorodi B, Patil AS. The Challenges and Recommendations for Gestational Diabetes Mellitus Care in India: A Review. Front Endocrinol (Lausanne). 2017;8:56.
Carolan M, Gill GK, Steele C. Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management. BMC Pregnancy Childbirth. 2012;12:99.
Ghaffari F, Salsali M, Rahnavard Z, Parvizy S. Compliance with treatment regimen in women with gestational diabetes: living with fear. Iran J Nurs Midwifery Res. 2014;19(7-1):S103-11.
Kim C, McEwen LN, Kieffer EC, Herman WH, Piette JD. Self-efficacy, social support, and associations with physical activity and body mass index among women with histories of gestational diabetes mellitus. Diabetes Educ. 2008;34(4):719-28.
Berg M, Sparud-Lundin C. Experiences of professional support during pregnancy and childbirth - A qualitative study of women with type 1 diabetes. BMC Pregnancy Childbirth. 2009;9:27-35.
King R, Wellard S. Juggling type 1 diabetes and pregnancy in rural Australia. Midwifery. 2009;25(2):126-33.
Bandyopadhyay M, Small R, Davey MA, Oats JJ, Forster DA, Aylward A. Lived experience of gestational diabetes mellitus among immigrant South Asian women in Australia. Aust N Z J Obstet Gynaecol. 2011;51(4):360-4.
Hoppichler F, Lechleitner M. Counseling programs and the outcome of gestational diabetes in Austrian and Mediterranean Turkish women. Patient Educ Couns. 2001;45(4):271-4.
Lavender T, Platt MJ, Tsekiri E, Casson I, Byrom S, Baker L, et al. Women's perceptions of being pregnant and having pregestational diabetes. Midwifery. 2009;26(6):589-95.
