Nurse-Based Management in Patients With Gestational Diabetes
Open Access
- 1 April 2003
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 26 (4), 998-1001
- https://doi.org/10.2337/diacare.26.4.998
Abstract
OBJECTIVE—To compare the rate of insulin treatment and perinatal outcome in women with gestational diabetes mellitus (GDM) under endocrinologist-based versus diabetes nurse-based metabolic management. RESEARCH DESIGN AND METHODS—In a retrospective analysis, maternal characteristics, rate of insulin treatment, and perinatal outcome of patients with GDM delivering between 1 January 1995 and 30 June 1997 (n = 244) receiving endocrinologist-based care were compared with those delivering between 1 July 1997 and 31 December 1999 (n = 283) who received diabetes nurse-based care. The diabetes nurse’s role was similar to that of an advanced practice nurse in the U.S. There were no changes in the metabolic goals and instruments or in obstetric and neonatal management. Quantitative data were compared with the Mann-Whitney U test and categorical data, with Fisher’s exact test. RESULTS—Maternal characteristics (age, BMI, family history of diabetes, prior glucose intolerance, gestational age, and blood glucose at diagnosis of GDM) did not differ between groups treated during the two periods. Rates of insulin treatment and perinatal outcome (hypertension, preterm delivery, cesarean section, low Apgar score, macrosomia, small- and large-for-gestational-age newborns, obstetric trauma, major malformations, hypoglycemia, hypocalcemia, polycythemia, jaundice, respiratory distress, and mortality) were also similar in both groups. CONCLUSIONS—Comparison of periods of endocrinologist-based and diabetes nurse-based metabolic management of women with GDM showed no differences in the rate of insulin treatment and perinatal outcome. This supports a more active role of nurses in the management of women with GDM.Keywords
This publication has 17 references indexed in Scilit:
- Gestational Diabetes MellitusDiabetes Care, 2002
- Impact of a diabetes midwifery educator on the diabetes in pregnancy service at Middlemore HospitalPractical Diabetes International, 2001
- Assessing the Impact of an Outpatient Education Program for Patients With Gestational DiabetesThe Diabetes Educator, 1995
- Gestational DiabetesMCN: The American Journal of Maternal/Child Nursing, 1994
- Intensified versus conventional management of gestational diabetesAmerican Journal of Obstetrics and Gynecology, 1994
- What Role for Nurse Practitioners in Primary Care?New England Journal of Medicine, 1994
- Summary and Recommendations of the Third International Workshop-Conference on Gestational Diabetes MellitusDiabetes, 1991
- Preparing the Woman with Gestational Diabetes for Self-CareJournal of Obstetric, Gynecologic & Neonatal Nursing, 1991
- O-Linked Oligosaccharides on Insulin ReceptorDiabetes, 1991
- Well-Child Care by Pediatric Nurse Practitioners in a Large Group PracticeAmerican Journal of Diseases of Children, 1976