Poster Australasian Diabetes in Pregnancy Annual Scientific Meeting 2013

COMPARISON OF TREATMENT AND MATERNAL OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES MELLITUS BY EDUCATION SETTING (#103)

Robyn A Barnes 1 , Glynis P Ross 1 , Catherine Finneran 1 , Adedapo Oni 1 , Jane Payne 1 , Jeff R Flack 1 2
  1. Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
  2. University of NSW, Sydney, NSW, Australia

Background: There is limited evidence on the effectiveness and outcomes of group versus one-to-one dietary education (with or without an interpreter) for women with GDM.
Aim: To compare group versus individual dietary education (with and without an interpreter), in terms of insulin therapy requirements and pregnancy outcomes in women with GDM.
Methods: All women who received one initial individual appointment with a dietitian (1-2-2011 to 31-1-2012) individually without an interpreter-(Individual) were compared to women who received initial education 1) individually with an interpreter-(Interpreter) (1-2-2011 to 31-1-2013) or 2) in a group setting-(Group) (1-2-2012 to 31-1-2013). All women received at least one individual follow-up appointment usually within two weeks of the initial education. The same initial dietary information was provided in all settings. Data collected were: insulin requirement, maternal weight gain, rates of SGA, LGA, mode of delivery, and rates of delivery complications. Data were compared by t-test or Chi-squared test. Fisher-Freeman-Halton exact test was used to detect differences in ethnicity. Statistical significance was p<0.05.
0>Results: Data were analysed for 194 (Group), 241 (Individual) and 140 (Interpreter) women. Group and Interpreter women were slightly older (32.3±4.9 and 32.9±5.5 versus Individual 31.1±5.1; p=0.016 and p=0.002 respectively). There was no difference in ethnicity or other baseline characteristics (Group versus Individual), however Interpreter patients differed by ethnic background, (more SE Asians in the interpreter group) and had a significantly lower pre-pregnancy BMI (see Table). The number of women requiring bolus insulin to control post-prandial glucose was not significantly different. The Table shows other parameters.

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Conclusion:  Changing to Initial Group education does not appear to compromise treatment and maternal outcomes in English speaking women with GDM. The significant differences seen in the Interpreter group require further investigation but may be due to language barriers or other cultural and/or physiological differences.