Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2019

A Retrospective Audit of the Efficacy of New Glycaemic Targets in the Treatment of Gestational Diabetes Mellitus (GDM) in the Sunshine Coast Hospital and Health Service District (SCHHS) (#60)

Bianca Nightingale 1 2 , E Gilbertson 1 2 , R Shakhovskoy 1 2 , A Lamprecht 1 2
  1. Royal Brisbane and Women's Hospital, Herston, QLD, Australia
  2. Sunshine Coast University Hospital, Birtinya, Queensland , Australia

New treatment targets in Gestational Diabetes Mellitus (GDM) were introduced in the Sunshine Coast Hospital and Health Service (SCHHS) in December 2016, as recommended by the Australian Diabetes in Pregnancy Society (ADIPS) consensus guidelines. This audit aimed to assess the effect on the health service and maternal and fetal outcomes at our facility.

A retrospective audit was undertaken of medical records of women treated in SCHHS for GDM. Outcomes in women treated over a six-month period prior to the introduction of new GDM treatment targets were compared with the outcomes of those treated over the same time period after the introduction. 284 patients were identified; 65 patients were excluded. Of the 219 patients, 32 were early-onset GDM, the remainder diagnosed between 26-28 weeks gestation. Service provision and maternal and fetal outcome data were obtained. Statistical analysis was performed on both groups.

The audit demonstrated no difference in outpatient service provision, nor increased maternal harm related to hypoglycaemia. There was a significant increase in the rates of IOL, but no statistically significant difference in birth weight, gestation at birth or LGA, possibly reflecting a change in obstetric practice. Statistical analyses for the early onset GDM group is being finalised, but raw data reveals similar results.

Stricter glycaemic targets currently utilised for the management of GDM in women at SCHHS have not significantly impacted on treatment burden for women, or on outpatient service provision. Early onset GDM had more impact on service provision, likely due to the longer treatment duration. The utility and accuracy of early OGTT has been highlighted recently and will be further discussed. In addition, in all groups, there was very poor uptake of the 6-week post-partum OGTT, indicating the need for increased education to both patients and primary care providers of the significantly increased lifetime risk of developing type 2 diabetes mellitus.

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