Graduation Date

Spring 5-7-2016

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Dr. Ann Anderson-Berry

Second Advisor

Dr. Corrine Hanson

Third Advisor

Meghan McLarney

Abstract

BACKGROUND: Gestational Diabetes Mellitus (GDM) is defined by glucose intolerance detected with the onset of pregnancy, and if gone undetected and untreated, can lead to morbidities for the mother and baby. Implementation of nutrition counseling can work to reduce the risk of complications through dietary modification promoted and adopted during pregnancy. Follow-up is important, as individual assessment is used to modify recommendations. GDM class and follow-up provided through the Diabetes Center of Nebraska Medicine covers and promotes proper management of blood glucose (BG) during pregnancy for women with GDM.

PURPOSE: The purpose of this study was to assess the impact of GDM class and follow-up with a Certified Diabetes Educator (CDE) on maternal and infant outcomes in women diagnosed with gestational diabetes as well as to establish rate of individual follow-up after GDM class attendance.

METHODS: A retrospective medical record review was conducted on women with GDM who attended GDM class between the dates of July 2014-January 2015. The primary maternal outcome was pregnancy weight gain and primary infant outcome was lowest blood glucose. Secondary outcomes include mode of delivery, birth weight, weight appropriateness for age, incidence of shoulder dystocia, involvement of NICU staff, and need for IV, heart, and respiratory support. An analysis of proportions and means, via Fischer’s Exact Test and Mann-Whitney U Test, was preformed, as appropriate, on variables between groups: mothers who attended class and follow-up verse those who only attended class. Rate of follow-up with a CDE post GDM class was also calculated.

RESULTS: Follow-up rate with a CDE after group class was 67.3%, leaving 32.7% without follow-up, which may be linked to increased gravidity of those in the non-follow-up group (1.3 vs. 2.81, p=0.004). No significant differences in maternal and fetal outcomes were identified between groups.

CONCLUSION: Findings indicate that group GDM class held at Nebraska Medicine’s Diabetes Center, on its own, successfully communicates information to women with GDM to aid in BG management and favorable outcomes.

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