title: Educational and intervention programmes for gestational diabetes mellitus (GDM) management: An integrative review.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) is a serious pregnancy disorder, which is linked to stillbirth, birth damage and later development of type 2 diabetes. Rates of GDM have increased dramatically in the past 20 years, related to obesity, sedentary lifestyles and ethnicity.
  
  
  OBJECTIVE
  The aim of this integrative review was to identify and to critically review existing self-management programmes for GDM.
  
  
  METHODS
  A search for studies published between 2000 and 2013 was conducted on: PubMed, CINAHL, Medline, OvidSP, ProQuest, SCOPUS and Wiley online library. GDM search terms included gestational diabetes mellitus; GDM, pregnancy diabetes. Search terms for self-management programmes, included educational programmes; lifestyle intervention; exercise, diet, weight management in pregnancy; life-style interventions.
  
  
  RESULTS
  Fifty papers were located in the search, and 12 were included in the review. Interventions fell into three main groups: (1) dietary and exercise interventions; (2) self-monitoring of blood glucose levels; and (3) counselling/behavioural interventions. This review found that although interventions varied in approach, most were successful in reducing insulin requirements; in reducing rates of macrosomia and hypertensive disorders, and in improving levels of knowledge and pregnancy outcomes. Only one study found that the intervention did not contribute some positive outcome.
  
  
  CONCLUSIONS
  Interventions that include adopting a low glycemic index diet and increasing levels of activity appear to be successful at reducing maternal blood glucose levels and reducing insulin requirements during pregnancy. Reducing maternal blood glucose levels, in turn, is associated with a reduction of macrosomia and maternal weight gain.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Carolan-OIah
mesh_terms: D000293:Adolescent; D000328:Adult; D000068959:Body Weight Maintenance; D016640:Diabetes, Gestational / Q000628:therapy*; D004032:Diet; D019468:Disease Management; D015444:Exercise; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008875:Middle Aged; D010353:Patient Education as Topic; D011247:Pregnancy; D012648:Self Care / Q000379:methods*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents