Practice Resources

Gestational Diabetes Management Resources

Gestational Diabetes Management Resources

Diabetes educators have many opportunities to assist women with gestational diabetes to live a healthier life, feel emotionally supported, have a successful pregnancy outcome, and lessen their chance of developing type 2 diabetes after their baby is born. Below you will find AADE’s new practice paper, some insight from one of the authors, educational courses, journal articles and tips from your fellow educators. 




New Practice Paper on Gestational Diabetes Mellitus

The new AADE Gestational Diabetes Management (GDM) Practice Paper covers diagnoses, treatment and prevention of GDM. Some of the key take-aways:    

Gestational Diabetes Mellitus Practice Paper

  1. GDM is something that can be delayed in women who eat healthy, exercise and actively try to prevent GDM. This paper helps the educator understand prevention of GDM and additionally, prevention of obesity and type 2 diabetes for the mother, post pregnancy.
  2. This paper gives detailed information on screening methods and how someone would progress from one screening to another based on results. Download a handy tip sheet with the guidelines.
  3. GDM is challenging but rewarding! While a woman with gestational diabetes may need to do a lot of work, it’s temporary and she knows there is an end and an end goal. This paper reviews those steps and the importance of setting smart goals.
  4. Women with gestational diabetes who cannot maintain a healthy blood sugar should be on approved medications. This paper reviews the approved medications, when to recommend those medications and the risks.
  5. Once a woman with gestational diabetes gives birth, the diabetes educator should be working with her on prevention. This paper offers specific recommendations for behavior modification, (being active and healthy eating), breastfeeding and healthy coping skills.   
     
   

   

Featured Blog Post

   

Nancy Drobycki, MSN, RN, CDE, writes about how she swore to one day help women with gestational diabetes receive the support they need from diabetes educators after her own diagnoses left her feeling overwhelmed and improperly supported. Read to find more info about the new gestational diabetes resources available through AADE.

Nancy Drobycki






Tips From Fellow Diabetes Educators

We went onto MY AADE NETWORK and asked AADE members for their best advice on GDM. Here are some of the responses: 


"I always tell them that it is not their fault! Telling them it is related to hormones from pregnancy instead of them being a failure usually brings tears of relief because they are convinced it is their fault."

—Barbara Walker, RN, CDE

"Important topics to cover: Impact of pregnancy hormones on insulin resistance and what insulin resistance means, and the importance of daily light-paced physical activity if not contraindicated." 

—Nancy Mack, RN, CDE, MSED

"I tell them, 'You can't study for it, so you didn't 'fail it.' It's outside of normal range.'"

—Juanita Daugherty, MSN, RN, CDE

"I always emphasize consistency with medications/insulin and timing of meals and snacks. I cannot count the number of women who saw dramatic changes to their blood sugars when they got on their own determined schedules and remained consistent with it. I also find it important to explain how their insulin needs and diet regimen might change as their pregnancy advances. This prepares them for ongoing changes and prevents them from becoming frustrated with ongoing GDM care."

Celia Balderas RN BSN

"At the initial visit I always introduce the idea that they may need medication. When I explain the meal plan, I explain that the goal is to eat healthy to support mom and the pregnancy. I spend time making sure she understands not to over restrict to control glucose and that if levels are too high then medication may be needed. Introducing the idea early and discussing it often helps prevent women from over restricting and decreases fear and guilt if medication is needed.

I also take the time to find out if they have friends or family members who have diabetes. I make sure the woman knows that glucose goals are lower in a pregnant woman as opposed to the non-pregnant person with diabetes. I have had many women that have gotten incorrect information from well-meaning family or friends and this leads to confusion and denial of their diagnosis during pregnancy. This confusion could lead to time wasted getting treatment started."

—Barbara Nadolny BSN, RN, CDE

"I give a talk on GDM to professionals reminding them about the realities of GDM – how to emphasize the importance of care but allay fears, piggy-backing on what was said. Either women are told, “don’t worry about a thing, this will go away when the baby is born” or they are frightened to death that their baby will be born with diabetes. Both WRONG – 60% of women with GDM go on to develop diabetes within 5-10 years so they ALWAYS need to be on the alert plus explaining the precise physiology of BG of Mom to fetus etc., is crucial. An abnormal intrauterine environment is proving to be responsible for many, many things now so we need to pay attention to that more than ever! Neonates will not have diabetes but these offspring are more prone to obesity, diabetes etc. if Mom’s glucoses were high."

—Lois Exelbert, MS, RN, BSN, BC-ADM, CDE, LCCE

Check out more tips and share your own on MY AADE NETWORK.







AADE Educational Programs Focusing on GDM

Pregnancy with Diabetes

Chapter Reading and Post-Test:

Pregnancy with Diabetes

From the Art & Science of Diabetes Self-Management Education Desk Reference, 4th Edition. This comprehensive chapter within this core publication for diabetes educators covers a wide range of topics related to preconception and postpartum care, complications that can arise in the mother or fetus, categories of increased risk for developing GDM and current recommendations for screening and diagnosing GDM. 

New Insights on Nutrition and Future Risks to Mom and Baby

Recorded Webinar:

Updates on GDM: New Insights on Nutrition and Future Risks to Mom and Baby

Recently revised nutrition practice guidelines are changing some commonly held beliefs and practices. For instance, intervention in the postpartum period may reduce or even prevent the development of type 2 diabetes in the future. This recorded webinar from 2017 will discuss new nutrition practice guidelines and type 2 risk reduction strategies in women with previous GDM and their children.

Gestational Diabetes

Online Course:

Gestational Diabetes

A self-paced, 4-module course delves into the diagnosis and pathophysiology of gestational diabetes. You’ll learn about nutrition and physical activity recommendations; medications to treat hyperglycemia in GDM; and recommendations for self-monitoring of blood glucose, checking of ketones and maternal and fetal monitoring. The course also covers the role of healthy coping, risk reduction and problem solving in GDM, and goes over management plans and issues during and after labor and delivery. 





AADE Journal Articles 

The Diabetes Educator

Dietary Self-Efficacy Predicts AHEI Diet Quality in Women with Previous Gestational Diabetes
Vol. 40, 5: pp. 688-699. First Published June 18, 2014
Erin Poe Ferranti, PhD, MPH, RN; K. M. Venkat Narayan, MD, MSc, MBA; Carolyn M. Reilly, PhD, RN, FAHA; Jennifer Foster, CNM, MPH, PhD, FACNM; Marjorie McCullough, ScD, RD; Thomas R. Ziegler, MD; Ying Guo, PhD; Sandra B. Dunbar, RN, PhD, FAAN, FAHA

Babies Need Healthy Moms: An Innovative Postpartum Screening and Education Class for Women who Had Gestational Diabetes Mellitus
Vol. 39, 2; pp.163-170. First Published January 22, 2013
Marie A. Frazzitta, DNP, FNP-C, CDE, MBA, Michele Anderson, NP, MS, WHNP-BC, Elizabeth Egan, RN, CDE

Stress and Anxiety in Women with Gestational Diabetes During Dietary Management
Vol. 40, 5: pp. 668-677. First Published May 29, 2014
Amy Leung Hui, RD, CDE, PhD (Candidate); Gustaaf Sevenhuysen, PhD; Dexter Harvey, PED; Elizabeth Salamon, MD

The Diabetes Educator Journal

 

AADE in Practice

A Patient-Centered Collaborative Approach to Insulin Pump Management During Labor and Delivery
Jane Wendel, MS, RN, BC-ADM, CDE
First Published February 13, 2018; Issue published: March 2018 

Educational Model in Prenatal Care to Manage Gestational Diabetes Mellitus in Spanish-Speaking Women
Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDE, FAADE; Liz Combs, MS, RD, LD, EdD-Candidate; María Gómez, DrPH, MPH, Postdoctoral Fellow
First Published October 19, 2015; Issue published: November 2015

Opportunities and Strategies for Meaningful Engagement with Women with Gestational Diabetes Mellitus
Amber McCulloch, MA; Ruth Lipman, PhD
First Published June 20, 2014; Issue published: July 2014

AADE in Practice Cover





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