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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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The ADIPS Pilot National Diabetes in Pregnancy Benchmarking Programme.

Jincy Immanuel1, Jeff Flack1,2,3, Vincent W Wong3,4

  • 1School of Medicine, Western Sydney University, 2560 Sydney, Australia.

International Journal of Environmental Research and Public Health
|June 2, 2021
PubMed
Summary
This summary is machine-generated.

This study found significant variations in managing pregnancies with hyperglycaemia and their outcomes. Benchmarking care for gestational diabetes mellitus (GDM) and pre-existing diabetes can improve results.

Keywords:
HbA1cauditgestational diabetes mellitushealthcare benchmarkingpregnancypregnancy outcomestype 1 diabetes mellitustype 2 diabetes mellitus

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • Pregnancy complicated by hyperglycaemia requires careful management.
  • Benchmarking care is essential for improving outcomes in high-risk pregnancies.

Purpose of the Study:

  • To assess the feasibility of benchmarking care for pregnancies with hyperglycaemia.
  • To identify variations in clinical practices and outcomes across different diabetes services.

Main Methods:

  • A retrospective audit of 10,144 pregnancies with hyperglycaemia (gestational diabetes mellitus, type 1 diabetes, type 2 diabetes) from 11 Australian and New Zealand diabetes services (2014-2020).
  • Comparison of treatment modalities, birth interventions, and neonatal outcomes across services.

Main Results:

  • Significant variations observed in treatment approaches (diet, metformin, insulin) and birth interventions (caesarean rates).
  • Wide ranges in adverse outcomes including preterm birth (3.7-9.4%), large for gestational age (10.3-26.7%), special care nursery admission (16.7-25.0%), and neonatal hypoglycaemia (6.0-27.0%).
  • Many women with pre-existing diabetes had poor pregnancy planning and first-trimester hyperglycaemia.

Conclusions:

  • Management of maternal hyperglycaemia and pregnancy outcomes varied significantly across services.
  • Continued benchmarking is crucial for identifying best practices and improving care for women with hyperglycaemia in pregnancy.