Gestational Diabetes Mellitus (GDM)
Gestational Diabetes Mellitus (GDM)
Gestational Diabetes Mellitus (GDM)
(GDM)
It is defined as abnormal carbohydrate
tolerance with onset or first detected during
pregnancy. This condition usually presents
late in second or during the third trimester
As obesity and GDM are frequently comorbid conditions, obesity and excessive gestational weight gain
may compound these risks in GDM6. Because fat is an endocrine organ and interacts with diabetes, it is possible that
the increased accumulation of fat has a differential effect on perinatal outcomes for women with GDM 7.
1. Antenatal supervision should be done at monthly intervals up to 20th weeks and thereafter
2. Diet : diet with 2000 -2500 KCAL /day od normal weight and restriction to 1200-1800
Kcal day for overweight women is recommended complex carbohydrates are preferred
without insulin. Human insulin should be started if fasting plasma glucose levels
exceeds 90mg/dl and 2 hours post prandial value is greater than 120mg/dl even on
diet control.
2. Excersie ( aerobic ,brisk walking) are safe in pregnancy and may obviate the need
of insulin therapy
hemoglobin should be done at the end of first trimester and 3 month thereafter .
6.Sonographic evaluation is helpful to detect fetal macrosomia ,growth retardation
8.The midwife should alert the women of her predisposition to UTI and vaginal
GOAL;
Demonstrate adequate hydration evidenced by stable vital
signs ,palpable peripheral pulse, skin turgor and capillary
refill well, individually appropriate urinary output
electrolyte levels within normal limits.
NURSING INTERVENTION
GOAL
1.Digest the amount of calories right
Shows the energy level is usually
Stable or increasing weight
NURSING INTERVENTION
Determine the patients diet and eating patterns and compared with foods
that can be eaten by the patient
RATIONALE
1.Identify deficiencies and deviations from the therapeutic need
Check weight regularly
2.Assessing adequate food intake (including absorption and utilization)
Identification of preferred food: include the needs of ethnic /cultural
3.If the patients food preferences can be included in meal planning this
cooperation can be pursued after discharge
Cont.…
4.Involve patients in planning the family meal as
indicated
5.Increase the sense of involvement provide information
on the family understand the patients nutrition
6.Give regular insulin treatment as indicated
Regular insulin has a rapid onset and quickly and
therefore can help move glucose into cells
NURSING DIAGNOSIS
3.Risk of infection related to hypoglycemia
Goal
Identify interventions to prevent/reduce the risk of
infection
Demonstrate techniques lifestyle changes to prevent
infection
NURSING INTERVENTION
Observed signs of infection and inflammation
RATIONALE
1. Patients may have entered with an infection that usually has sparked a state
of ketoacidosis or may have nosocomial infections
2. Improve efforts to prevention by good hand washing for all people in
contact with the patients including the patients themselves
3. Prevention cross infection
4. Maintain a septic technique invasive procedures
5. High glucose levels in blood would be the best medium for the growth of
germs
Cont.…
6.Provide skin with regular care and earnest
7.The peripheral circulation may be disturbed that
puts patients At increased risk of damage to the
skin irritation and infection
8.Makes changes to the position effective
coughing and encouraged deep breathing