Background: GDM (gestational diabetes mellitus) increases the lifetime risk of maternal T2DM by 7-fold and increases the risk for maternal and fetal complications. Prenatal education on nutrition, exercise, and T2DM risk among women with GDM increases the likelihood of postpartum diabetes screening. However, access to diabetes education is limited. To address this gap, we created four GDM training modules for nurses and community health workers (CHW) and studied changes in knowledge, attitudes, and intentions before and after training completion.

Methods: Online modules (45-60 minutes each with interactive cases and integrated knowledge check questions) were distributed through multiple professional organizations to clinical staff providing care for women with GDM with optional pre- and post-evaluation surveys.Data were not normally distributed. We described baseline population characteristics, GDM knowledge, attitudes, and intentions using median score and interquartile range. We evaluated changes in scores on knowledge, attitude, and intention scales before and after training using non-parametric Wilcoxon matched pair signed rank tests.

Results: Seventy-eight individuals completed baseline evaluation (99% female, median age 40, 65% white non-Hispanic; 54% LPN/RN, 22% CHW, 24% other degree) . Nineteen individuals completed all 4 modules and post-training assessments. GDM knowledge improved significantly after training (median pretest - posttest score: 56% to 78%, p<0.001) . The biggest improvement in knowledge was noted in monitoring, medications, and hypoglycemia prevention (51% to 77%, p<0.001) . Intention to recommend diabetes prevention methods also increased after training (median pretest - posttest score: 35.5 to 39.4, max. score 40, p=0.009) .

Conclusion: Interactive online modules improved knowledge and intention to recommend diabetes prevention methods. Access to such curricula is critical for improving access to diabetes education among patients.


P.Krutilova: None. R.C.Williams: None. R.Morey: None. C.Field: None. R.Byrth: None. M.D.Tepe: Other Relationship; Merck & Co., Inc. C.J.Herrick: Consultant; Teladoc Health, Other Relationship; Eli Lilly and Company, Merck & Co., Inc.


NICHD K23HD096204NIDDK T32DK007120

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at