Diabetes in Pregnancy
Maternal care contributes to child survival, reduction in maternal infections, neonatal morbidity, and mortality. The American Diabetes Association® (ADA) recognizes women’s health deserves individualized study, care, and advancement. Diabetes in pregnancy, including gestational diabetes (GDM), is a growing problem in the U.S.
Gestational Diabetes
GDM is a major cause of adverse maternal, fetal, and neonatal outcomes and predisposes women to significant health problems later in life. To address these concerns, the ADA has launched a Women’s Health Initiative (WHI), aiming to improve health outcomes for women with GDM by utilizing equitable and sustainable models of care through the adaptation of best practices, promotion of care and education guidelines, and formation of a multidisciplinary professional education program.
Women’s Health Initiative Continuing Education
The WHI is offering a free online continuing education (CE) course essential for diabetes health professionals that provide care and education for women with GDM, including but not limited to midwives, nurse practitioners, physicians, physician’s assistants, certified diabetes care and education specialists, registered dietitian nutritionists, pharmacists, social workers, community health workers, and doulas. This four-module program will cover:
- GDM Basics: Importance of screening for GDM at 24–28 weeks of pregnancy
- GDM Treatments: Elements of the treatment plan for women with GDM
- GDM Technology: Role of blood glucose monitoring in women with GDM
- Healthy Equity: Implications of stigma, racism, disparity, and social determinants of health in women with GDM
Earn two FREE CE credits by completing this program.
__________________________________________________________
WEBINAR: Gestational Diabetes and the Impact of Race, Societal and Lifestyle Factors on Black Maternal Health Disparities
This webinar reviews the impact that race, societal and lifestyle factors have on black women in materal health. Ndidiamaka Amutah-Onukagha, PhD, MPH, CHES, Sue-Ellen Anderson-Haynes, MS, RDN, CDCES, LDN, NASM-CPT and Erin George, CNM share their expertise. We address the black maternal health crisis and the rise of GDM and what solutions and improvements that can be made during treatment.
Target Audience: This activity is intended for: Doulas, Midwives, Community Health Workers, Physicians, Physician Associates, Nurses, Nurse Practitioners, Registered Dietitians and Pharmacists.
Learning Objectives: This activity will address evidence-based, peer-reviewed clinical data and expert opinion on quality diabetes management. Learning Objectives:
- Identify and describe the historical and contextual factors that contribute to persistent maternal health disparities in the U.S.
- Compare the Black maternal health crisis with the rise of GDM
- Review diagnosis and etiology of GDM in pregnancy and how GDM impacts pregnancy, birth, and postpartum
- Recognize the importance of developing and implementing solutions to address systemic and lifestyle factors that affect Black women with GDM
- Emphasize the critical importance of focusing on the fourth trimester as an intervention point to reduce risks related to long-term cardiometabolic health
Earn one FREE CE credit for this webinar.
WEBINAR: Gestational Diabetes Mellitus: A Glimpse into the Future
This webinar reviews important early screening for diabetes in women who are pregnant as well as screening for gestational diabetes. Jacqueline LaManna, PhD, APRN, ANP-BC, BC-ADM, CDCES, FADCES, shares her expertise as a provider and CDCES. We address subsequent postpartum and the timeline for ongoing screening in women with a history of gestational diabetes. Leveraging screening data will help inform timely care and education for women into their future.
Target Audience: This activity is intended for: Doulas, Midwives, Community Health Workers, Physicians, Physician Associates, Nurses, Nurse Practitioners, Registered Dietitians and Pharmacists.
Learning Objectives: This activity will address evidence-based, peer-reviewed clinical data and expert opinion on quality diabetes management. Learning Objectives:
- Address evidence-based, peer-reviewed clinical data and expert opinion on quality diabetes management
- Develop a diabetes screening plan for pregnant women based upon assessed risks
- Establish a follow-up clinical plan based upon results of diabetes screening during pregnancy
Earn one FREE CE credit for this webinar.
Infographics: Gestational Diabetes (GDM) Guidelines
GDM Facts
Although GDM is a common medical problem during pregnancy, there has been a significant increasing trend in GDM cases, reaching a 30 percent increase between 2016 and 2020, as seen in the graph below.
Further, GDM prevalence is strongly related to race and culture. These factors, in combination with the rising trends and increased maternal and fetal risks, provide the WHI with the opportunity to address health outcomes as they are related to GDM. With the rising trend of GDM in recent years, it is equally important to understand that the following are risk factors of developing GDM:
- Obesity
- Physical inactivity
- Advanced maternal age
- Multiparous
- Family history of type 2 diabetes
- Ethnicity
- Previous macrocosmic child
- GDM in previous pregnancy
- Polycystic ovarian syndrome
The following images provide some examples of relationships between risk factors and GDM cases.
The increasing trends and risks related to GDM illustrate the importance of bringing awareness to diabetes in pregnancy. If GDM is not managed, diabetes can confer significant maternal and fetal risks including:
- Fetal anomalies
- Spontaneous abortions
- Preeclampsia
- Fetal demise
- Macrosomia
- Neonatal hypoglycemia
- Hyperbilirubinemia
- Neonatal respiratory distress syndrome
- Increased risk for GDM in subsequent pregnancies
For more information about the care for women during pregnancy, see the section on management of diabetes in pregnancy in the Standards of Care in Diabetes.
Scientific Advisory Council (SAC) Members:
- Cameual “Camie” Wright, MD, OB/GYN, MBA
- Camille Powe, MD, Endocrinology
- Cynthia Lynch, CNM
- Desirae Michalisko, CNM
- Garfield Clunie, MD, OB/GYN
- Hillary Melchiors, PhD, CD (DONA), LCCE
- Jacqueline LaManna, PhD, APRN, ANP-BC, BC-ADM, CDCES, FADCES
- Jessica Anderson, DNP, CNM, WHNP, FACNM
- Keisha Zackery, MSL
- Kristina Naseman, PharmD, MPH, CDCES, BCACP
- Lisa Saul, MD, MFM
- Rafael Perez-Escamilla, PhD, Public Health
- Teri Reilly, MS, RD, CDN, CDCES
Continuing Education (CE) Learning Committee:
- Cassandra Henderson, MD, CDCES
- Claudia Schwide-Slavin, MS, RDN, CDCES
- Jessica Lynn, DNP-C, CNM, MSN, CDCES
- Kristina Humphries, MD
- Kristina Naseman, PharmD, MPH, CDCES, BCACP