Primary care nurse practitioner practices to lower type 2 diabetes risks in women with a history of gestational diabetes mellitus

Abstract

Background: Women with a gestational diabetes mellitus (GDM) history have increased lifetime type 2 diabetes (T2D) risk, with 16 times greater risk 3 to 6 years after the pregnancy, compared with women without GDM. Offspring from diabetes-complicated pregnancies also face increased health risks.Purpose: The study purpose was to describe the primary care practices of nurse practitioners (NPs) aimed at reducing T2D-related health risks in women with a history of GDM.Methodology: Florida-licensed primary care NPs (n = 47) completed a 57-item online survey that included an 8-item scale about recommended practices to reduce T2D risks for women with GDM history. Descriptive statistics, Chi Square test, and Fisher exact test were conducted.Results: Most (67%) participants "often/always" screened for T2D every 1-3 years per guidelines, but only 31.8% "often/always" advised about pregnancy planning/preconception T2D assessment. Compared with "none" or #2 hours of GDM care education, participants with >2 hours were more likely (p < .05) to "often/always" perform five recommended practices: 1) counsel about increased T2D risks; 2) educate about self-advocacy for T2D screening; 3) T2D screening every 1-3 years; 4) counsel about breastfeeding to reduce T2D risk; and 5) discuss postpartum weight loss and increased physical activity to lower T2D risk. Conclusion:Findings indicate inconsistent care practices and suggest that >2 hours of education about care of women with GDM history may increase primary care NPs performing recommended practices to reduce T2D risks and prevent health problems for women and future offspring.Implications: Nurse practitioner education is needed involving care of women with GDM history to mitigate risks for T2D.

The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta‐analysis of analytical observational studies

“…Hyperglycemia from GDM is transient and short‐lived and may not be long enough to initiate or exacerbate PD. As a result, periodontitis patients are likely to be the cause of GDM and not a result of it 25–28 . The results of the present meta‐analysis also confirm this hypothesis and confirm the development of GDM in pregnant women with periodontitis.…”

“…As a result, periodontitis patients are likely to be the cause of GDM and not a result of it. [25][26][27][28] The results of the present meta-analysis also confirm this hypothesis and confirm the development of GDM in pregnant women with periodontitis. The meta-analysis results of Lima et al in 2015 showed that there is no positive and significant relationship between periodontitis and GDM, which contradicts the results of the present meta-analysis.…”