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NURSING CARE FOR WOMEN WITH GESTATIONAL DIABETES
Hellen Mascarenhas da Silva1
Geane Silva Oliveira2
Abstract: INTRODUCTION: Gestational diabetes is characterized as a multifactorial etiology and
dicult to control, which makes a broad approach necessary, in which the success of treatment is di-
rectly linked to nursing actions developed for this population, especially in prenatal care. The nurse,
as an educator, must guide the pregnant woman regarding the disease, its symptoms and drug thera-
py, providing guidance on healthy habits, such as nutrition and physical exercise, clarifying doubts
during the course of pregnancy and encouraging self-care. OBJECTIVE: To investigate nursing care
for women with gestational diabetes in the literature. METHODOLOGY: qualitative research of an
exploratory nature, of the integrative review type. The article searches were carried out based on
the selection of descriptors registered in DECS (Health Sciences Descriptors): Nursing Care, Ges-
tational Diabetes, High-Risk Pregnancy. Searches for articles were carried out in the virtual heal-
th library (VHL), with the help of the Boolean operator AND”. The online databases used were:
LILACS, BDENF - nursing. For the inclusion criteria, the following were used: complete articles
available in full, indexed in databases, in Portuguese, with a time frame of the last 10 years (2014 to
2024). Exclusion criteria include: theses, dissertations, reports, abstracts, monographs. RESULTS
AND DISCUSSION: According to the eligibility criteria, 18 articles were found in LILACS, BDE-
NF - nursing among the studies searched, 4 of them were selected based on the chosen topic. During
the process of reviewing each study, checking the inclusion and exclusion criteria, reading the titles,
reading the abstracts, reading the total articles, only 6 studies were selected in this review. CONCLU-
1 Specialization in Family Health (420 hours) by Santa Maria College with TCC entitled “Di-
culties of Nurses in the treatment of pressure ulcers in hospital and PSF of Cajazeiras - PB”; Postgra-
duate in teaching from Santa Maria College.
2 Nursing at Santa Maria University Center
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SION: Therefore, it can be concluded that nurses have an important responsibility during the prenatal
care process, with regard to early diagnosis and adequate treatment of gestational diabetes mellitus.
Keywords: Nursing; Diabetes mellitus; gestation
INTRODUCTION
Gestational diabetes mellitus (DMG) is a more common metabolic problem in pregnancy
and is dened as glucose intolerance of dierent degrees with diagnosis during the second or third
quarters of pregnancy, which may or may not persist after delivery. DMG is characterized by having
a multifactorial etiology and dicult to control, which makes a broad approach in which the success
of treatment is directly linked to nursing actions developed for this public, especially prenatal care. In
addition, proper and early diagnosis of diabetes not only allows you to perceive changes in glucose
tolerance but also allow the adoption of therapeutic measures to preserve the health of the maternal and
fetal binomial (Jacob et al., 2014; Araújo et al. ., 2013).
In addition, some studies show that DMG reaches up to 25% of pregnant women in the world,
according to data from the Brazilian Society of Diabetes, causing complications to both womens and
child’s health. The prevalence of this pathology worldwide ranges from 2.4% to 7.2% and this variable is
preached even when it persists after pregnancy. In Brazil, DMG ranges from 3.5% to 18%. In addition,
it is possible to observe that 7% of pregnancies results in an average of 200,000 cases per year has some
complication caused by gestational diabetes mellitus (Marques et al., 2020; Batista et al., 2021; Sousa
et al. 2022; SILVA et al., 2016).
Risk factors that contribute to the occurrence of DMG are overweight or obesity, arterial
hypertension or preeclampsia, polydramnium, age equal to or more, family history of diabetes in rst-
degree relatives, malformations, polycystic ovarian syndrome, Maternal stature of less than 1.5 meters,
obstetric history of macrosomia, fetal or neonatal death (Mariano TF et al., 2021).
Early diagnosis of pregnant women with DMG is of paramount importance, so it is essential
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that the exams are performed in the rst quarter when prenatal care begins. Tracking is performed
around the twenty -fourth week of gestation, through fasting glucose examination, in which plasma
glucose measurement is done after 8 hours fasting and also by the oral glucose tolerance test around the
twentieth Eighth Week during prenatal consultation (Almeida et al., 2017; Santos et al., 2021, Ferreira
et al., 2021).
However, nursing consultation becomes crucial as it allows you to identify and implement
actions to promote, prevent and recover the health of the pregnant woman. Regarding gestational
diabetes it is essential that the nurse has knowledge of related symptoms such as polyuria, polydipsia,
polyfagia and spontaneous weight loss. From these symptoms, the pregnant woman needs to be carefully
evaluated and agility in order to investigate other manifestations that provide the clinical suspicion of
the DMG (Mariano TF et al., 2021).
With this, it is necessary to be emphasized and studied the performance of nursing in care and
monitoring in the health of the pregnant woman, specically the gestational diabetes, the main theme of
this work, in order to obtain greater accuracy and appropriate knowledge during the treatment period.
In addition, the following guiding question is established: What will be the nursing care directed to
women with gestational diabetes? Thus, the present study aims to conduct a search in the literature on
how to attend women with gestational diabetes by the nursing team.
METHODOLOGY
This study is an integrative literature review based on a qualitative exploratory research
strategy. Integrative review is a research method that seeks to integrate and synthesize results from
dierent studies on a particular theme. The construction of the literature review is divided into six
stages for its construction: preparation of the guiding question, search or sampling in the literature, data
collection, critical analysis of the included studies, discussion of results and presentation of integrative
review (Whittemore; KNAFL, 2005 ; SOUZA; SILVA, 2010) (SOUZA; SILVA; CARVALHO, 2010).
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This study was based on the following guiding question: What is the importance of the nurse
in assistance directed to women with gestational diabetes? The surveys of the articles were done, in
January and February 2024, from the selection of the descriptors registered in the Decs (descriptors in
Health Sciences): Nursing, Diabetes Mellitus, Pregnancy. Searches for the articles were performed at
the Virtual Health Library (BVS), with the help of Boolean operator “and”. The online databases used
were: Lilacs (Latin American and Caribbean Literature in Science), and BDENF - Nursing.
During the research, 18 articles were found, all of them in Lilacs, among the studies sought, 6 of
them were selected in the face of the chosen theme, but in the process of reviewing each study, verifying
the criteria of inclusion, exclusion, reading of the titles, reading Of the summaries, total reading of the
articles, only 4 studies were selected in this review.
The data were selected as shown in Figure 01. In addition to the methodological steps, the
results are described in Table 01 and discussed according to the relevant literature
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Figure 1. Flowchart of the chosen articles
Results
According to the eligibility criteria were found 18 articles in Lilacs, and BDENF - Nursing
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among the studies sought, 4 of them were selected in the face of the chosen theme. During the process of
reviewing each study, verication of inclusion criteria, exclusion, reading titles, reading of summaries,
total reading of articles, only 4 studies were selected in this review.
The data were selected as presented in Table 1, and the results were discussed according to
the relevant literature.
Title Author/Year Objectives Main outcomes
Diabetes mellitus
gestationary and the
implications for nursing
care in prenatal care
SCHMALFUSS,
Joice Moreira,
2014.
The objective of this
study was to identify
the nursing care
provided to women
with GMD during
pre-Natal, evidenced
in the scientic
literature, between
the years 2004 and
2013.
Such ndings intensify that, The nurse plays a
fundamental role in the care of these subjects,
collaborating in the control of the pathology, gestac
outcomeIonal without complications and in a
satisfactory way, as well as in the birth of a healthy
baby without neonatal complications.
Nursing care for patients
with gestational diabetes
mellitus: a literature
review.
SHIMOE, Cintia;
Bonani et al., 2021
The objective was to
analyze the evidence
in the literature
on nursing care in
Primary Care to
Patients who had
Gestational Diabetes
Mellitus.
The result of the research showed Importance of
health professionals, especially the nursing team has
the Responsibility to guide pregnant women about the
disease, Plan and execute care that Provide habits of
Healthy life.
Validation of a nursing
discharge plan for high-risk
pregnant and postpartum
women
COLLI, Monique;
ZANI, Adriana
Valongo, 2016.
The objective of this
study was to validate
a nursing discharge
plan for high-
risk pregnant and
postpartum women
using the Delphi
technique.
The main items for The self-care recommended by
the literature are related to the dietary guidelines that
include a balanced, fractionated diet, following the
prescribed diet plan; guidelines for self-administration
of insulin, highlighting the technique of application
and care with the medication;Monitoring of the
glycemic level and identication of signs of
hypoglycemia or hyperglycemia.
Instrument for nursing
consultation for pregnant
women with diabetes
mellitus
FILGUEIRAS,
Thaynara Ferreira
et al., 2019
Build and valIdar
instrument to assist
in the nursing
consultation of
pregnant women with
diabetes Mellitus.
A Nursing consultation for pregnant women with
diabetes mellitus, Favor the promotion of quality
of life, adoptionOf healthy lifestyle habits and the
realization of self-care practices, and glimpse the
emotional, psychological and social aspects that can
inuence endocrine changes in the gestational phase.
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DISCUSSION
Study evidenced by Schmalfuss et al 2014 showed that the prevalence of gestational diabetes
is the main cause of maternal and child complications, early identication of diagnosis is of paramount
importance for better disease management. Quality prenatal care accompanied by a multidisciplinary
team allows the patient to have more safety in the management of the disease. The interaction of
professionals, especially that of the nurse with the patient, is paramount, since he is a professional who
is directly linked to care.
Shimoe et al 2021 intensies the importance of nursing management in treatment women with
gestational diabetes, nursesguidelines regarding healthy eating and the benets of physical activity
allows pregnant women to adopt a new life habit and promote improvements in your self -care. The
promotion of this conversation between patient and nurse during prenatal care brings improvements
in the pregnant womens choices and decreases possible complications that would occur until delivery.
It is of paramount importance for the nurse to work health education actions for the pregnant
woman and her family members who are directly involved in pregnancy, such as: approach to the
diabetes theme during pregnancy, stimulating the pregnant woman to develop self -care, encourage the
realization of Daily exercise with the help of family members until delivery, changes in lifestyle, so that
the chances of DMG complications are minimal. (Schmalfuss et al., 2014).
In line Filgueiras et al 2019, it emphasizes the importance of continuous training of nursing
professionals to provide better assistance to women with gestational diabetes mellitus. Clinical evaluation
through nursing consultation allows the professional to identify situations that will endanger the health
of pregnant women and the fetus, and thus provide solutions that avoid future problems.
Monique Coll et al 2016, emphasizes that a quality prenataler can bring several benets to the
pregnant woman and the fetus, the early identication of gestational risks is directly linked to fetal health
promotion. Identifying and treating DMG early from preventing the fetus from having malformations
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and changes in the growth of the concept, so it is of paramount importance that the nurse that the nurse
and other professionals perform a quality prenatal care (FILGUEIRAS et al, 2019)
CONCLUSION
In short, it can be concluded that the nurse plays a key role in the management of gestational
diabetes, as he is a professional who accompanies the pregnant woman throughout the prenatal care.
Its professional training allows you to bring clear and true information to the patient with gestational
diabetes, reducing the chances of developing other disorders until the moment of delivery. Conversation
and empathy is critical to the nurse and patient bond, as it promotes the improvement of assistance for
a quality prenatal care.
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