Table 1—

Sketch of the program of care for women with GDM in the periods of endocrinologist-based and diabetes nurse-based management

Endocrinologist-based management
Diabetes nurse-based management
Endo-crinologistDiabetes nurseEndo-crinologistDiabetes nurse
First appointment
 Information about the disorderXX
 Diet calculationXX
 Blood test requestXX
 Instruction
  Diet (timing and nutrient exchange)XX
  Self-monitoring of blood glucose and urine ketonesXX
Second appointment
 Medical visit to identify health backgroundXX
Follow-up visits during pregnancy*
 Glycemic profile revisionXX
 Blood test request (HbA1c and fructosamine) every 4 weeksXX
 Diet revisionXX
 Decision on initiation of insulin TxXX
 Instruction on insulin administrationXX
 Instruction on treatment of hypoglycemiaXX
 Modification of diet and insulinXBackupX
After delivery follow-up
 Blood test request including thyroid Ab and if negative, OGTT and lipid profileXX
 Blood test checkup, weight, blood pressureXX
 Information about type 2 diabetes prevention and cardiovascular risk factorsXX
  • The diabetes nurse role in this report would be similar to that of an advanced practice nurse in the U.S.

  • *

    * For follow-up visits during pregnancy, frequency was weekly or biweekly, and targets of blood glucose control were <90 mg/dl fasting and <120 mg/dl 1 h postprandial.