Date of Completion
Dr. Janeen Amason
Aim: This integrative review aimed to review studies on the risk of developing type II diabetes (T2DM) after a diagnosis of gestational diabetes mellitus (GDM) and available programs to mitigate this risk. The research question that guided this review was: For women diagnosed with gestational diabetes, what programs are available to decrease risk factors for developing T2DM later in life?
Background: Women who experience GDM have an increased risk of developing T2DM at a rate of eight times higher than those with no history of GDM (Song et al., 2017). The risk for T2DM after a diagnosis of GDM can be as high as 50% (Auvinen et al., 2020). Long-term morbidity and mortality can be decreased when women with a history of GDM are screened, and interventions are implemented postpartum (Uzoh et al., 2019). Modifiable risk factors can be reduced with early implementation of effective interventions (Goveia et al., 2018). Less than half of women with GDM receive appropriate diabetic screening and follow-up postpartum.
Methods: Articles were located by searching electronic databases including CINAHL, PubMed, Medline (MESH), Clinical Practice Guidelines (ACOG, ADA, CDC, AWHONN), Diabetes Prevention Project, US Preventative Services Taskforce, Gray Literature, Google Scholar, Hand search (JOGNN, NWH), Citation search, and Librarian support. Whittemore and Knafl’s (2005) framework for data collection and synthesis was utilized for this integrative review. Articles were reviewed from 2017 to December of 2022.
Results: This integrative review revealed seven studies related to available programs to implement diet and lifestyle modifications to reduce the risk of T2DM after a diagnosis of GDM. These studies research a variety of interventions including digital applications, video coaching, text support, virtual reality, or face to face sessions to evaluate program effectiveness. Themes found in the studies include weight loss, improved diet and calorie intake, and participant satisfaction. Barriers are often present in the achievement of lifestyle modifications as postpartum women experience fatigue and parenting stressors. Resolution of these barriers are a main focus of program development.
Conclusion: To reduce the risk of developing T2DM later in life, programs should be implemented that are patient centered with a focus on diet and lifestyle changes. Programs should allow for a variety of digital applications as well as in person sessions and should address barriers that would prevent goal achievement and maternal self-efficacy.
Keywords: diabetes in pregnancy, gestational diabetes, risk for type II diabetes in women with gestational diabetes, systematic review and gestational diabetes, integrative review and gestational diabetes, diabetes testing in the postpartum period, diabetes in the postpartum period