Poster Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

THE IMPACT OF DIETARY EDUCATION SETTINGS ON GESTATIONAL DIABETES MELLITUS OUTCOMES IN WOMEN DIAGNOSED ACCORDING TO THE NEW AUSTRALASIAN DIABETES IN PREGNANCY CRITERIA (#158)

Laura C Kourloufas 1 , Robyn A Barnes 1 , Jeff R Flack 1
  1. Diabetes Centre, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia

Background: There is limited evidence on the effectiveness and outcomes of group versus individual education for women with Gestational Diabetes Mellitus (GDM), especially for those diagnosed by new Australasian Diabetes in Pregnancy Society (ADIPS) 2014 criteria.  

Aim: To compare group versus individual GDM education modes of care outcomes, since new diagnostic criteria implementation. 

Methods: Our Diabetes Centre adopted ADIPS 2014 criteria on 1-Mar-2016 (Fasting ≥5.1mmol/L, 1 hour ≥10mmol/L, 2 hour ≥8.5mmol/L). Outcomes of women who received group education were compared to women who received individual education with dietitian and diabetes educator Mar-2016-June-2017. The same information was provided in both settings however modes of delivery differed. Group sessions included English speaking PowerPoint presentation and interactive activities. Individual sessions involved predominately women requiring an interpreter and tailored advice based on an individual clinical assessment. Data collected were: insulin requirement, maternal weight gain (total and in excess of Institute Of Medicine recommendations), caesarean section, infant weight and percentile, SGA and LGA. Data were compared by t-test or Chi-squared test. Statistical significance was p<0.05.

Results: Of 522 women, (356 group versus 166 individual), there was, respectively, no significant difference in baseline characteristics for: age (30.9±5.2 vs 31.4±5.3), pre-pregnancy Body Mass Index (26.8±5.5 vs 25.9±5.8), HbA1c (5.2±0.4 vs 5.1±0.4), OGTT fasting (5.1±0.6 vs 5.1±0.6) or 2 hour BGL (7.4±1.8 vs 7.8±1.8), and weeks gestation at diagnosis (24.4±5.3 vs 23.2±6.2). However, a greater percentage of women from Middle Eastern (28.9% vs 18.8%), South East Asian (30.7% vs 14.9%), African (10.8% vs 3.1%) and Pacific Islander (2.5% vs 1.8%) backgrounds, received individual education. There were no significant differences in treatment or pregnancy outcomes between group and individual education (see Table).

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Conclusions: In our high-risk cohort of women diagnosed with GDM according to ADIPS 2014 criteria, both group and individual education resulted in similar treatment and birth outcomes.