Nursing Care Challenges in a GDM Mother with a Hypoglycemic Neonate: A Case-Based Insight

Gestational Diabetes Mellitus (GDM) is associated with adverse maternal and neonatal outcomes, including macrosomia, neonatal hypoglycemia, polycythemia, and respiratory distress. Timely nursing interventions, including early glucose monitoring and feeding support, play a pivotal role in preventing complications.

A 35-year-old multigravida woman (G3P1A2L1) was diagnosed with GDM at 24 weeks via oral glucose tolerance test (OGTT). Initially managed with medical nutrition therapy, she later required insulin in the third trimester due to persistent hyperglycemia. At 38±2 weeks, she delivered a 3.7 kg male infant via normal vaginal delivery. The neonate was closely monitored for hypoglycemia, with blood glucose values of 54, 58, 54, and 54 mg/dL at 2, 4, 6, and 8 hours of life, respectively. He also exhibited borderline polycythemia (hematocrit 60%), which improved with exclusive breastfeeding. Nursing interventions included early initiation of breastfeeding, vigilant glucose and hematocrit monitoring, hydration assessment, and parental counseling. The mother's postnatal blood glucose normalized by the third day, and she was counseled on lifestyle modification and follow-up to prevent future Type 2 diabetes mellitus.

This case underscores the critical role of nurses in the early recognition and management of neonatal complications related to GDM. Proactive glucose screening, feeding support, hematocrit monitoring, and caregiver education are essential to reducing neonatal morbidity and ensuring long-term health outcomes.