Impact of Antepartum Case-Based Learning on Glycemic Control and Self-Management Skills in Women with Gestational Diabetes: A Patient-Centered Non-Parallel Quasi-Experimental Study.

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a growing global concern. GDM increases the risk of complications in both mothers and infants, including preeclampsia, macrosomia, and a higher likelihood of developing type 2 diabetes later in life. This study aimed to assess whether integrating case-based learning (CBL) with traditional education could improve glycemic control and patient outcomes in women with GDM.

Methods: This non-parallel quasi-experimental study compared CBL interventions with traditional education in GDM women. Pregnant women from September 2022 to March 2023 received only traditional education (control group), whereas those from April to September 2023 received both case-based and traditional education (intervention group). The primary outcomes included fasting and 2-hour postprandial blood glucose level changes after the intervention. The secondary outcomes included self-management behavior changes (Self-Management Scale for Women with GDM), self-efficacy (Pregnancy Exercise Self-Efficacy Scale), GDM understanding (self-developed questionnaire), satisfaction, pregnancy weight gain, and macrosomia incidence.

Results: A total of 140 GDM women were included, with the intervention and control groups containing 70 participants each. The intervention group showed significantly greater reductions in fasting and 2-hour postprandial blood glucose levels than the control group (p<0.001). In addition, the intervention group demonstrated notable improvements in self-management behaviors, GDM knowledge, and patient satisfaction. The incidence of macrosomia was also significantly lower in the intervention group (1.6% vs 10.8%, p=0.034), indicating better neonatal outcomes.

Conclusion: CBL could be incorporated into traditional education in GDM women to improve their self-management and self-efficacy for better glycemic control and pregnancy outcomes. Healthcare providers should be educated on the CBL and relevant policies should be developed to facilitate the implementation of CBL in the clinical practice.