47 Review Article - Sushmitha Ramona Karkada

Review article
Awareness on Gestational Diabetes Mellitus (GDM) and

compliance to management among pregnant women- A
narrative review
Meena Konsam, Sushmitha Ramona Karkada*, Laveena Anitha Barboza
Email: sushmitha.karkada@manipal.edu
Abstract
Being one of the subtypes of Diabetes Mellitus (DM), Gestational Diabetes Mellitus (GDM) is one of the transient
conditions which is suffered commonly by pregnant women and affects both maternal and neonatal health. Timely
awareness and prompt compliance will translate in adapting healthy life style practices, prevention of complications
and early diagnosis of the burden in later years. The present paper is reviewed to assess the awareness regarding GDM
and compliance to management among pregnant women with GDM.
Key words: Awareness, compliance, gestational diabetes mellitus (GDM), knowledge, pregnant women
Introduction have no known risk factors (International Federation

of Gynaecology and Obstetrics, 2018).
Gestational diabetes is a condition in which some
women are unable to keep their blood glucose level According to International Diabetes Federation
within the normal range and develop hyperglycaemia (IDF), worldwide about 60 million of women in the
during the second half of pregnancy. The condition reproductive age have suffered with diabetes. “One in
may revert back to normal after delivery and affects seven births is affected by gestational diabetes. IDF
about one in eight to ten women and few times causes estimates that 6 million births are affected by some
adverse effects to mother and child (Rani & Begum, form of hyperglycaemia during pregnancy in India
2016). Hence, prenatal screening is fundamental in early alone, of which 90% are due to GDM” (International
diagnosis and treatment of GDM during pregnancy. Diabetes Federation, 2017). The GDM rate in India
is 26.3% and it is highest in the World (Cho, 2017). A
The risk for GDM is higher among Asians, women community-based study conducted in South India by
with advanced maternal age above 30 years; obese or Seshiah, et al. (2008), reports prevalence of GDM was
overweight; positive family history of diabetes (first 17.8%, 13.8% and 9.9% in urban, semi urban and rural
degree relatives) or previous history of GDM or had areas respectively based on the two-hour post glucose.
problems in past pregnancies such as a large baby, Thus the prevalence of GDM is steadily increasing over
stillbirth or repeated abortions and few women who the past decades. Thus compliance with the treatment
schedule is crucial in managing GDM. Appropriate
Meena Konsam1, Sushmitha Ramona Karkada2, Laveena awareness and prompt compliance will translate in
Anitha Barboza3
adapting healthy life style practices, prevention of
1. Lecturer, Department of Obstetrics and Gynaecological
Nursing, Canara College of Nursing, Karnataka, India complications and early diagnosis of the burden in
2. Asst Professor, Dept of OBG Nursing, Manipal College of later years. Exploring factors like awareness about the
Nursing, MAHE, Manipal
3. Lecturer, Dept of Fundamentals of Nursing, Manipal College
disease condition and ways to manage in terms of diet,
of Nursing, MAHE, Manipal exercise, compliance to drugs, self-care, and early risk
Manuscript received: 26 Nov 2018 perception would help the midwives and healthcare
Revision accepted: 22 Dec 2018 professionals provide better care and direct most
*Corresponding Author appropriate measures that would promote wellbeing.
How to cite this article: Konsam, M., Karkada, SR, & Barboza, LA. (2019). Awareness on Gestational Diabetes Mellitus (GDM) and
compliance to management among pregnant women- A Narrative review. Manipal Journal of Nursing and Health Sciences, 5(1), 47-50.
Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1 47

Konsam, M: Awareness on Gestational Diabetes Mellitus
Awareness on gestational diabetes mellitus (GDM) performance, 114 (38%) had average performance and
A cross-sectional study was conducted to assess the 18 (6%) women had weak performance on management
awareness of GDM among 500 pregnant women with of GDM. The study also revealed that majority 206
GDM in Belagavi, Karnataka. The study revealed (68.7%) women had good attitude and 94(31.3%) had
that eight (1.6%) of pregnant women had excellent average attitude towards GDM. Moreover, the study
knowledge, 109 (21.8 %) of pregnant women had found that higher the education level, the attitude of
good knowledge, 288 (57.6%) of pregnant women the pregnant women towards GDM was good. The
had average knowledge and 95 (19%) of pregnant study implicated that there was need of formulating
women had poor knowledge. The study emphasized plan to provide education among women related to
the need to create awareness about GDM through GDM (Davoodi, Sepehri, Ganjali, & Bagheri, 2016).
regular screening and uses of mass media (Vineeta,
Mahantashetti, Ganachari, Kambar, & Ghatnatti, A cross sectional descriptive study was conducted
2018). to assess the knowledge and awareness of GDM
among 200 antenatal women at Pondicherry. The
A cross-sectional survey study conducted among 100 study revealed that 27 (13%) antenatal women had
pregnant women with GDM in South India revealed good knowledge about GDM (mean score knowledge
that 45 (45%) women had known about GDM and 7.72) and its risk factors, but awareness on screening,
majority 85 (85%) women had average knowledge treatment and consequences were found to be poor
regarding GDM. Majority 62 (62%) women had (p<0.01) (Elamurugan & Arounassalame, 2016).
favourable attitude and 32 (32%) had an unfavourable
attitude towards DM. Moreover, the study revealed A cross-sectional study was conducted on 166 GDM
that as awareness towards condition enhanced, women in Malaysia to evaluate the knowledge about
women developed positive attitude to management GDM and its association with glycaemic level. The
(r=1, p =.146). The study also found that 77 (77%) study revealed that 91 (54.6%) of the pregnant women
of the pregnant women had perceived low risk of had positive family history of DM. About 145 (87.3%)
developing type 2 DM and 23 (23%) had high risk for pregnant women reported that they followed diet
developing type 2 DM in the future (Noronha, et al., control therapy to manage GDM. The study result
2018). also showed that 94 (54.4%) women had adequate
knowledge about GDM diet. The study indicated that
A cross sectional study done at antenatal clinics in working women had significantly higher knowledge
Samoa among 149 pregnant women showed that scores than housewives. Moreover, the study also
around 82 (58%) women were aware about GDM revealed that glycaemic control was significantly
that occurs for the first time of pregnancy and also associated with their knowledge about the disease
revealed that 40 (49%) women identified that family (p<.01) (Hussain, Yusoff, & Sulaiman, 2015).
history of GDM is the major risk factor of developing
GDM followed by pre-pregnancy obesity 19(23%). Even though GDM is a public health problem, there
Knowledge about GDM among antenatal women exists a need to promote general awareness regarding
helped them to transform or adopt healthier lifestyle the disease condition, its management in terms of diet,
practices, improved healthcare-seeking pattern and activity, self-care, compliance to drug regime, train and
better self-care (Price, Lock, Archer, & Ahmed, 2017). sensitize healthcare professionals to promote early
detection and its management.
A descriptive study was conducted to assess the
awareness, attitude and performance to gestational Compliance to management of GDM
diabetes among 300 pregnant women with GDM GDM, a transient condition in pregnancy poses adverse
at Zabol, Iran. The study revealed that 110 (36.7 %) long and short term effect on mother and child.
women had good awareness, 175 (58.3%) had average In order to minimize these consequences judicious
awareness and 15 (5%) had weak awareness about recognition, optimum management, adequate follow-
GDM. Of total 300, 168 (56%) women had good up and compliance to management is essential.
48 Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1

A qualitative study was conducted among five pregnant Conclusion

women diagnosed with GDM to assess the self- GDM is often linked with greater antepartum risk for
management in Australia. The study revealed that mothers and a higher possibility for developing type
the factors contributing, barriers and facilitators of 2 DM in future. Infant born by a woman with GDM
GDM self-management were time pressure, physical has high risk for developing jaundice, hypocalcaemia,
constraints, social constraints, limited comprehension macrosomia, hypoglycaemia, respiratory distress
of requirements and medication. The study found that syndrome, polycythaemia and metabolic disorder.
women, who had low socio-economic and migrant The awareness of GDM among antenatal women is
backgrounds had low self-management to adhere to important for the outcome of pregnancy and to achieve
GDM dietary and exercise guidelines (Carolan, 2013). a healthy lifestyle. There is an essential need to emphasis
health care provider in planning health teaching
A descriptive study conducted by Mahmoud, program on the promotion of good compliance to
Mohammed, & Mohamed, (2018) to assess compliance management, prevention and its complication of
of 130 women with GDM to scheduled therapeutic GDM among antenatal women.
regimen in Egypt found that 43 (33.1 %) of the
Sources of support: None
pregnant women had satisfactory compliance with
Conflict of interest: None declared
therapeutic regimen and 87 (66.9%) of the pregnant
Source of support in form of grants: None
women had unsatisfactory compliance.
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Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1 49

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50 Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1

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Review article

Awareness on Gestational Diabetes Mellitus (GDM) and

Introduction have no known risk factors (International Federation

Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1 47

48 Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1

A qualitative study was conducted among five pregnant Conclusion

Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1 49

50 Manipal Journal of Nursing and Health Sciences | January 2019 | Volume 5 | Issue 1

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