Dietaryadviceongdmmothers-an audit

Abstract

BACKGROUND: Gestational Diabetes Mellitus (GDM) is considered a global problem and in Sri Lanka. It is emerging as a common complication in pregnancy. Hence, an audit was undertaken to evaluate dietary advice given to GDM mothers as it is the primary modality of treatment. OBJECTIVE: To ascertain the standard of dietary advice given to GDM mothers attending a tertiary care ,. ater.STUDY TYPE: Retrospective study. STUDY SETTING: Tertiary care center. STUDY SAMPLE: 49 consecutive GDM mothers, who was diagnosed in the ANC and ward. METHOD: Study was carried out from 1st of June to 1st of August 2006. A questionnaire was developed to evaluate the standard of the dietary advice in accordance with the unit policy. RESULTS: Out of the population 39% were in the age group of 21-30 and 61% in the 31-40 age category. Out of the total sample 96% of mothers received advice on a diabetic diet but out of which, only 4% had been supplemented with written format. The SHO, registrar, and senior registrar contributed dietary advice to 37% of the mothers while nursing officers have advised to 22%. The intern medical officers have advised 19% of mothers, while public health rnidwives, MOH have accounted for advising 15% and 5% respectively. The dietician advised only 2% of the mothers. Out of the mothers who were interviewed following the dietary advice, 69% understood the advice satisfactorily. Furthermore 24% stated that they understood the advice partially and 7 % reported poor understanding. In addition 16% of the mothers had requested repeated dietary advice. Finally, 56% reported satisfaction with the overall dietary management of the above medical complication. CONCLUSIONS AND RECOMMENDATIONS: The dietary advice given in our study population is unsatisfactory, considering the fact that the diet control is the primary modality of treatment in GDM. We recommend that advising on diet is a joint responsibility of medical officers, nursing officers, midwives and dieticians. Such advice should be solid and tailored to follow the Sri Lankan dietary habits and expectations. In addition the explanations should be done in a simple manner with use of a dietary advice leaflet according to a common protocol and each hospital should have a specialized supplemented with written format. The SHO, registrar, and senior registrar contributed dietary advice to 37% of the mothers while nursing officers have advised to 22%. The intern medical officers have advised 19% of mothers, while public health rnidwives, MOH have accounted for advising 15% and 5% respectively. The dietician advised only 2% of the mothers. Out of the mothers who were interviewed following the dietary advice, 69% understood the advice satisfactorily. Furthermore 24% stated that they understood the advice partially and 7 % reported poor understanding. In addition 16% of the mothers had requested repeated dietary advice. Finally, 56% reported satisfaction with the overall dietary management of the above medical complication. CONCLUSIONS AND RECOMMENDATIONS: The dietary advice given in our study population is unsatisfactory, considering the fact that the diet control is the primary modality of treatment in GDM. We recommend that advising on diet is a joint responsibility of medical officers, nursing officers, midwives and dieticians. Such advice should be solid and tailored to follow the Sri Lankan dietary habits and expectations. In addition the explanations should be done in a simple manner with use of a dietary advice leaflet according to a common protocol and each hospital should have a specialized dietician.