Preventing and responding to increasing incidence of Gestational Diabetes Mellitus

Gestational Diabetes Mellitus (GDM) is estimated to increase in Australia with around 12 – 14% of pregnant women (about 17,000 women every year) developing this largely preventable condition. (Department of Health, 2015) (NDSS, 2016).

In December 2016, there were 1,282 women in the Eastern Health catchment with GDM on the National Disability Services Scheme. Women with GDM are at significant risk of developing type 2 diabetes as well as complications with pregnancy and labour. Babies of women who have had GDM have increased risk of obesity, insulin intolerance and diabetes.

What did we do?

This project, in partnership with members of the Eastern Region Diabetes Initiative Steering Group (DISG), aimed to understand the prevalence of GDM in at risk population groups in the Eastern Health catchment (Knox, Manningham, Maroondah, Whitehorse and Yarra Ranges local government areas) and community knowledge of GDM; research evidence of effective prevention and management initiative; and develop and trial interventions that address some of the findings.

The project undertook statistical analysis, a literature review, key informant interviews with health professionals and community workers, consultation with peak diabetes organisations and health services, and interviews with women with GDM.

Key outcomes

This project highlighted the benefits of identifying high risk patients early with potential for less patients to need insulin management. The findings from the literature review and consultations led to these key recommendations:

  1. Improve support within the health system for women during and after pregnancy to manage GDM and reduce risk.
  2. Build the capacity of general practitioners to support women at risk.
  3. Improve systems integration to ensure identification and management of women at risk of and with GDM is optimal.
  4. Address the obesogenic environment.

As a result of these findings, Eastern Health aimed to improve the coordination of care for women with GDM who are in shared care by improving communication with general practitioners. A flow chart of the current and optimal processes was prepared and the software vendor developed an automated, electronic letter for GPs and set up a secure message delivery system for letters and discharge summaries for GPs. This care coordination solution is transferable to other areas of Eastern Health that communicate patient diagnoses and discharge summaries with general practitioners.

Carrington Health investigated the potential for an online service delivery model and digital strategies framework suitable for community health, such as a specific website and regular text messaging, establishing the basis for future intervention with potential to have an impact.

Key lessons learned were:

  • The importance of partnerships and collaboration in researching health issues and exploring solutions.
  • Learning about what has been tried, tested and works from current and past interventions is vital to understanding the issue and solutions.
  • It is vital to ensure that lived experience of the issue is at the forefront of any solutions developed.

How did the PCP contribute to this success?

The IEPCP ensured the success of the project through thorough research, project management, collaboration, and partnership development. As a longer-term member of the DISG in the region, the IEPCP had well-established relationships with project partners. The IEPCP has expertise in population health-prevention, bringing a different focus to this project, which provided insights to the evidence and interventions researched. As a non-service provider, the IEPCP also had the level of objectivity and oversight required without an organisational stake in the outcomes.

Full Report

Case Study

We acknowledge the Wurundjeri people and other peoples of the Kulin nation as the traditional owners of the land on which our work in the community takes place. We pay our respects to their Elders past and present.

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