Implications for practice
This study has important implications for practice, as
rates of GDM continue to increase globally, particularly
among women with risk factors such as obesity, lower
socio-economic status and migration from world regions
of high GDM risk. It is therefore important that strategies
are adopted to encourage these groups of ‘at risk’
women to self-manage their GDM. Such selfmanagement
will reduce the incidence and severity of
GDM related complications. The greatest challenge
faced by health professionals, engaged in the care of
women with GDM, is to provide sufficient and appropriate
education and support at what is a stressful time in a
woman’s pregnancy. Most women describe being
shocked and upset at their diagnosis of GDM and take
some time to adapt. At the same time, there is a relatively
narrow window of opportunity for women to master
the complex tasks of GDM self-management, and
thus reduce their hyperglycaemia. Dwindling health
resources add to this conundrum, as educational
resources are already stretched, often where they are
most needed.
There is a need for targeted educational resources for
women with GDM, and earlier studies indicate that
initiatives that address the cultural context of the group
in question, may produce the best results [55,61]. Additionally,
there is strong evidence to suggest that emotional
support from the woman’s partner/husband/family
improves adherence to GDM self-management regimens
and, with this in mind, a family approach to GDM education
may produce better results. This careful targeted
approach may effect more successful dietary management and may thus reduce the percentage of
women requiring insulin to control their condition. Successful
GDM self-management, in turn, is associated
with lower rates of serious pregnancy complication and
serious infant morbidity. It is also associated with a
lower risk of later developing type 2 diabetes.