Effects of transtheoretical model-based cognitive load dietary education on glycemic control and pregnancy outcomes in gestational diabetes mellitus: A retrospective propensity score-matched study.

This study aimed to evaluate the association between a dietary education approach grounded in the transtheoretical model and cognitive load theory and glycemic control and pregnancy-related outcomes in patients diagnosed with gestational diabetes mellitus (GDM). A retrospective analysis was performed using clinical data from 126 pregnant women with GDM who received care at our hospital between September 2021 and September 2023. Participants were grouped based on the type of nursing intervention received: a control group that underwent standard care and an observation group that received an additional cognitive load-informed dietary education program based on transtheoretical model. Baseline characteristics, including age, education, delivery method, GDM history, gestational age, body mass index, residential area, family history of diabetes, and monthly household income, were collected. Propensity score matching was applied to balance the baseline data and reduce selection bias, resulting in 42 matched cases per group. Glycemic indicators, urinary ketones, self-care ability, self-efficacy, and the occurrence of negative pregnancy outcomes were assessed and compared post-intervention. No significant differences were noted between the 2 groups before the intervention in fasting plasma glucose, 2-hour postprandial glucose, urinary ketones, self-care capabilities, or self-efficacy (P > .05). After receiving the dietary education, the observation group was associated with significantly lower levels of fasting plasma glucose, 2-hour postprandial glucose, and urinary ketones, alongside higher scores in self-management and self-efficacy compared to the control group (P < .05). Moreover, the rate of adverse pregnancy outcomes was markedly reduced in the observation group (11.90%) compared to the control group (30.95%) (P < .05). A dietary education strategy integrating cognitive load principles and the transtheoretical model was associated with improved health literacy, self-management, glycemic control, and maternal and neonatal outcomes among women with GDM.