Diabetes, caffeine, painkillers

Nurses improve management of diabetes during pregnancy

J Advanced Nurs (2013) Doi:10.1111/jan.12277

A nurse-led programme that cared for pregnant women with diabetes improved management and reduced adverse neonatal outcomes, an Australian study found.

The study compared outcomes between 112 pregnant women with diabetes managed with usual care and 149 whose care was coordinated by a diabetes nurse practitioner.

As part of nurse-led care, women attended a 'one stop' clinic that involved an obstetrician, midwives, a credentialed diabetes educator (a nurse) and a dietician. Twenty-six women had pre-existing type 1 diabetes, 11 had pre-existing type 2 diabetes and 195 had gestational diabetes.

The proportion of women referred to dieticians rose from 16% before the intervention to 92% after the introduction of the nurse-led programme. The proportion referred to diabetes educators rose from 32% to 97%. The proportion with gestational diabetes who used insulin, rather than diet and exercise alone, increased from 10% to 53%. On the other hand, the proportion of women referred to physicians for diabetes care declined from 48% to 15%.