Most women in gestational diabetes education program have post-partum glucose impairment
Click Here to Manage Email Alerts
More than half of the women of Asian ethnicity who participated in a gestational diabetes education program had some form of glucose impairment 4 to 12 weeks after delivery, according to two speakers.
In general, only 42% of women with gestational diabetes complete a postpartum OGTT, even though 50% to 70% of women with gestational diabetes develop type 2 diabetes later in life, according to presenter Donna Jornsay MS, CPNP, BC-ADM, CDCES, diabetes program manager and clinical specialist at Sutter Health Mills-Peninsula Medical Center in California. Jornsay and Carrie Arnold, MS, RD, CDCES, a registered dietitian at Sutter Health, designed an education program mitigate those numbers.
“The class was designed to serve two functions,” Jornsay told Healio. “First, to increase the percentage of postpartum women who complete the test and, second, to provide them with some education to help them delay developing type 2 diabetes.”
The program has testing and education components. Participants begin their day by taking a 75-g OGTT with the lab running the tests during a 2-hour education group session of three to eight women. The women are also invited to bring their babies and spouses. The class begins with information on type 2 diabetes, and the women a given a chance to identify risk factors that apply specifically to them, Arnold said during the presentation.
The class reviews maintaining a healthy lifestyle and adjusting to changes in the family or lifestyle post-pregnancy. Arnold said the discussions surrounding these topics frequently lead to very emotional moments.
“We talk about how [gestational diabetes] changed their life, how it may have impacted their stress, their sleep, their relationships with friends, family an spousal concerns, how their support is at home,” Arnold said. “This often sparks a pretty heavy conversation with the participants where they get an opportunity to share their story and share their experience with other people who have been through something quite similar.”
The class wraps up with discussions about planning for future pregnancies and the impact on the mother’s and baby’s health. Participants will typically receive their glucose test results later that day.
The program began in 2019 and had 57 women complete it prior to its temporary suspension in March due to COVID-19. Jornsay focused on the results of the Asian women who participated (n = 37), composing more than half of the total participants.
Out of the Asian participants, only 16 reported normal results on their postpartum glucose test. Another 16 had impaired glucose tolerance, three had impaired fasting glucose and two were diagnosed with type 2 diabetes.
Jornsay said the results showed how quickly glucose impairment can progress from gestational diabetes.
“We’re talking about women that are already back to ideal body weight, and yet they’re still having this impairment,” Jornsay said. “Not 10 to 20 years out, 4 to 12 weeks out.”
Even though more than half of the participants reported some type of glucose impairment, Jornsay noted that only 46% of them needed medication. The remaining women could manage their glucose level with diet and exercise.
After the test results are communicated to the women, results are sent to their obstetrician. Women with glucose impairment are referred to their primary care provider and are recommended interventions such as a healthy diet, regular exercise regimen and metformin. Additionally, any of the women who are planning to have another child in the future are advised to discuss their gestational diabetes and have their blood sugar checked prior to conception.
Jornsay and Arnold said they are hoping to continue the program in September and expand their findings.
Collapse
Arnold CA and Jornsay DL. Can Education Put the Brakes on the Progression of GDM to Type 2 Diabetes? Presented at: Association of Diabetes Care and Education Specialists Annual Meeting; Aug. 13 - 16, 2020; (virtual meeting).
Read more about
Click Here to Manage Email Alerts