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Living With Gestational Diabetes in a Rural Community

Abraham, Kylene DNP, APRN-C; Wilk, Nancy DNS, WHNP-C

MCN: The American Journal of Maternal/Child Nursing: July/August 2014 - Volume 39 - Issue 4 - p 239–245
doi: 10.1097/NMC.0000000000000047

Purpose: To explore the lived experiences of women with a recent history of gestational diabetes mellitus (GDM) who live in rural communities.

Study Design and Methods: A phenomenological study exploring the lived experiences of 10 women aged 25 to 49 years with a history of GDM in the last 5 years. Data were collected through two semistructured short interviews that were conducted in person or by telephone.

Results: Five themes emerged: Authentic emotion, Judgment, It's only a matter of time, I can't do this alone, and Missed opportunities. Strong emotions were experienced at the time of diagnosis. Some women felt judged by healthcare professionals and others based on having GDM. Some were concerned about future risk of developing Type 2 DM. There is a lack of understanding of GDM by women at the time of diagnosis and after they give birth. The majority of women in this study noted that healthcare professionals did not discuss future implications of Type 2 DM and the need for follow-up glucose testing. Many opportunities are missed to provide education and support to facilitate lifestyle interventions.

Clinical Nursing Implications: Self-management of GDM is more likely to be successful if women understand GDM and believe that they can manage it. Nurses should use every opportunity to provide women with GDM information and available resources. This may be important in rural communities where fewer resources are available for support. Nurses should recognize that negative emotions may affect motivation of women to understand and ask questions about GDM. Nurses can favorably influence the return rates for postpartum glucose testing by raising awareness of implications of GDM on future health.

The diagnosis of gestational diabetes has major implications for women during their pregnancy and beyond. The voices of participants in this study can be beneficial in guiding nursing care for women newly diagnosed with diabetes during pregnancy.

Kylene Abraham is a Visiting Assistant Professor, St. John Fisher College, Wegmans School of Nursing, Rochester, NY. She can be reached via e-mail at

Nancy Wilk is a Visiting Assistant Professor, St. John Fisher College, Wegmans School of Nursing, Rochester, NY.

The authors declare no conflicts of interest.

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