In with the new, out with the old? – Applying new GDM diagnostic criteria in a community setting — ASN Events
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In with the new, out with the old? – Applying new GDM diagnostic criteria in a community setting (#388)

Debra Clare 1 , Marisa Nastasi 1 , Sonia Middleton 1 , Kate Logie-Smith 1
  1. Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia

Background: Gestational diabetes (GDM) affects between 5-14% of pregnancies Australia wide.1

The education service at the Baker IDI Heart and Diabetes Institute provides an outpatient GDM clinic offering appointments and email support with both a Credentialled Diabetes Nurse Educator (CDNE) and an Accredited Practising Dietitian (APD). It was estimated that the introduction of these new ADIPS diagnostic guidelines would see GDM rates increase as found in a number of prospective studies2-3. 

Aim: To determine if the gestational diabetes (GDM) service at Baker IDI has been impacted by increase in prevalence and workload with the implementation of the new ADIPS guidelines. 

Method: A report was generated from our medical database of women who attended education services in 2015 for GDM. Results of seventy-two women were included in the data set. Results of glucose tolerance tests (GTT) were reviewed and compared against previous recommended diagnostic guidelines. The commencement of insulin was also included in the data set. 

Results: 18% (n=13) of the 72 women included in this data (p=0.139), would not have been diagnosed with GDM using previous diagnostic guidelines. Of these 18% (n=13), 53% (n=7) required insulin. Despite this increase in prevalence not being statistically significant, it indicates an increase in workload hours and patient contact at Baker IDI for the education services team.

With the introduction of the new guidelines the prevalence rate was projected to increase in many centres which is indicated by the results of our data review2-4. Data was not assessed for risk factors associated with GDM. 

Conclusion: With the new ADIPS guidelines introduced, there was a predicted increased prevalence of GDM in many centres2-4.At Baker IDI, new criteria also saw an increase in this GDM prevalence, increasing resources required to provide GDM education.

 

  1. The National Diabetes Services Scheme (NDSS) (Diabetes Australia) Available at: https://www.diabetesaustralia.com.au/gestational-diabetes
  2. Shang.M and Lin.L, IADPSG criteria for diagnosing gestational diabetes mellitus and predicting adverse pregnancy outcomes, Journal of Perinatology, February 2014, 34:100-104
  3. Moses RG, SanGil F, Morris G, Petocz P, Garg D. Impact of the potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust 2011; 194: 338 – 340.
  4. Metzger B, Sacks D, Hadden D, Maresh M, Deerochanawong C, Dyer A, Lowe L, Coustan D, Hod M, Oats J, Persson B. Frequency of Gestational Diabetes Mellitus at Collaborating Centers Based on IADPSG Consensus Panel – Recommended Criteria: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Diabetes Care March 2012; 35:526- 528
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