Guidelines for the nursing management of gestational diabetes mellitus: An integrative literature review.
Gwendolyn Patience Mensah, Wilma Ten Ham-Baloyi, Dalena R M van Rooyen and 1 others
PMID 31871693WHAT IT FOUND
Eighteen guidelines for nurses and midwives covered GDM screening, pregnancy, labour and postnatal care, but recommendations differed and many did not address low-resource barriers.
Key findings
01The review synthesized eighteen included guidelines into two themes: early screening and diagnosis, and nursing management during pregnancy, labour and postpartum.
02Most guidelines addressed nursing management during pregnancy and early screening, while intrapartum nursing management was least covered.
03Most guidelines favored screening at 24-28 weeks and using a 2-hour 75 g oral glucose tolerance test, but some guidelines recommended other tests.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This review summarizes guideline recommendations, not patient outcomes, so it cannot tell you whether following them improves maternal or neonatal health. Some guidelines may have been missed because the authors had limited database access. Selection and appraisal relied on a small number of reviewers, which can introduce bias. The included guidelines differed in screening timing, tests, glucose targets and follow-up intervals, so there is no single agreed practice. Most guidelines did not address low-resource barriers, and the review could not assess the strength of evidence behind each recommendation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not treat this as evidence that any GDM guideline reduces complications. It is a synthesis of existing recommendations, and the authors could not grade the strength of evidence behind each recommendation.