The impact of the IADPSG guidelines for gestational diabetes mellitus on a secondary hospital population
Viner R, Hird K and Basu A
University of Notre Dame, Australia
Rockingham General Hospital, Australia
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Abstract
Background: In 2015, the Australian criterion for diagnosing Gestational Diabetes Mellitus (GDM) has changed to mirror the internationally applied IADPSG criterion. Researchers have predicted that this would increase the incidence of GDM due to the lower fasting threshold and a new 1-hour diagnostic value. Aim: The aim of the study was to quantify the impact of the IADPSG guideline on the incidence of GDM at a secondary hospital in Australia. It was hypothesised that the incidence of GDM would increase with no associated difference in maternal or foetal outcomes. Materials & Methods: Only women with well-controlled GDM continue their pregnancy at this secondary hospital, with those uncontrolled or requiring insulin are referred to the tertiary hospital. All births between January-June 2015 (n=899) and 2016 (n=925) were included in the study. Pregnancies with GDM in 2015, under the previous criteria (n=71) and those in 2016, under the IADPSG criteria (n=56) were identified. Routine clinical data including blood glucose results, maternal and foetal outcomes were analysed. Results: After applying the IADPSG criteria at RGH, the incidence of GDM decreased from 7.90% to 6.05%, a 23% relative decrease that was not statistically significant. In the same period in 2016, the referring tertiary hospital had a significantly higher incidence of 23% (X2=116.92, p<0.01). There was no significant difference in maternal or foetal outcomes under the IADPSG guideline. Conclusion: In the secondary hospital, the IADPSG criterion has not increased the incidence of GDM as expected. Literature on the new incidence of GDM is lacking and more data is required to quantify the effect of the IADPSG guideline in Australia.
Biography
Viner R has completed her Bachelor of Medicine, Bachelor of Surgery at The University of Notre Dame Fremantle, Western Australia, Australia. She holds a previous Bachelor’s degree in Forensic Science and this comprises her Honours Research Degree completed in 2016. She will soon start to work at Fiona Stanley Hospital as an Intern in 2017 with hopes to become an Obstetrician & Gynaecologist and to further her research in Gestational Diabetes.
Email: rosieviner@iinet.net.au
