Gestational diabetes mellitus (GDM) is a condition that every nurse, RN nurse, or nursing student should understand. It affects about 6–9% of pregnancies and is tested frequently on the NCLEX because of its risks to both mother and baby. Having this topic in your nursing bundle will help you provide safer, more effective care.
🩺 What is Gestational Diabetes?
Gestational diabetes occurs when a pregnant woman develops high blood glucose levels due to insulin resistance that appears during pregnancy. Unlike type 1 or type 2 diabetes, GDM usually resolves after delivery, but it still poses risks if not managed well.
Key points for NCLEX and nursing practice:
✅ Usually develops in the second or third trimester
✅ Increases risk of macrosomia (large baby)
✅ Raises the chance of birth trauma
✅ Can cause neonatal hypoglycemia
✅ Increases maternal risk of developing type 2 diabetes later
🟡 Screening for Gestational Diabetes
Registered nurses and nurse educators must know when and how to screen.
✅ Initial screening: around 24–28 weeks gestation
✅ Two methods commonly used:
- One-step (OGTT): 75g oral glucose tolerance test
- Two-step: 50g glucose challenge, then a 100g OGTT if abnormal
NCLEX tip: memorize normal values for glucose tolerance tests to catch abnormal results!
🩹 Nursing Management of GDM
Management focuses on keeping blood glucose within target ranges to protect both mother and fetus. Here’s what RN nurses should remember:
✅ Encourage dietary changes (carb control, frequent small meals)
✅ Promote regular exercise
✅ Monitor blood glucose frequently
✅ Educate about self-monitoring with glucometers
✅ Administer insulin if diet/exercise are insufficient
✅ Schedule regular fetal monitoring (NST, biophysical profile)
Nursing care priorities include preventing complications like preeclampsia, macrosomia, and shoulder dystocia at delivery.
👩⚕️ Patient Teaching for Gestational Diabetes
Teaching is critical. Nurses should cover:
✅ Why blood sugar needs control
✅ How to check glucose
✅ How to recognize signs of hypo- or hyperglycemia
✅ Importance of healthy eating
✅ Benefits of physical activity
✅ Follow-up after delivery (postpartum glucose testing)
Empowering the patient and their family to manage GDM will improve outcomes dramatically.
📝 NCLEX Reminders
👉 Screen all pregnant patients between 24–28 weeks
👉 Control glucose through diet and exercise first
👉 Know insulin may be needed
👉 Watch for complications like preeclampsia and macrosomia
👉 Add to your nursing bundle for high-yield maternal health review
💡 Cheat Sheet for Nursing Students
✅ GDM = glucose intolerance in pregnancy
✅ Screen with OGTT at 24–28 weeks
✅ Treat with diet, exercise, insulin if needed
✅ Teach self-monitoring and warning signs
✅ Always plan follow-up after delivery