Effect of a new self-care guide package on maternal and neonatal outcomes in gestational diabetes: A randomized control trial

Background: The aim of this study was to determine the effect of a new self-care guide package on gestational diabetes mellitus (GDM).

Methods: This randomized clinical trial was conducted on 152 women with GDM. The intervention group was provided with the self-care guide package and three face-to-face educational sessions. The control group received routine clinical services, including physician visits and short training regarding nutrition, blood glucose control, and insulin injections. The primary outcomes were fasting and 2-h postprandial blood glucose and self-efficacy measured at the beginning of the study and 1 month after the end of the intervention. Secondary outcomes included Apgar scores, birth weight, type of delivery, and newborn hospitalization. Data were analyzed using t-tests, as well as Mann-Whitney, Chi-squared, and linear and logistic regression tests.

Results: The mean (±SD) self-efficacy score was higher in the intervention than control group (74.4 ± 7.0 vs 36.4 ± 5.2, respectively; P < 0.001). There was no significant difference in mean fasting plasma glucose between the two groups (P = 0.163), but mean 2-h postprandial plasma glucose was lower in the intervention than control group (105.1 ± 17.6 vs 127.2 ± 20.4 mg/dL, respectively; P < 0.001). There were no significant differences in the weight and age of the neonate at delivery or in the type of delivery between the two groups. However, the newborn hospitalization rate was higher in the control group (P < 0.001).

Conclusion: The use of a self-care package had a positive effect on maternal self-efficacy and 2-h postprandial plasma glucose, Apgar scores, and neonatal hospitalization.