Live Well with Gestational Diabetes (GDM) Udani Abeypala, Lucille Chalmers, Denise Burdett-Jones, Michelle Trute

Diabetes Queensland, GPO Box 9824, Brisbane Qld 4064

www.diabetesqld.org.au

Changes to diagnostic criteria have the potential to increase GDM

rates and demand for support. Additionally, low awareness of risks

during and post pregnancy hinders healthy lifestyle behaviours and

screening.(1)

• Engage and support women at diagnosis to improve self-management

and communication with healthcare professionals.

• Emphasise importance of adaptation/maintenance of healthy lifestyle

behaviours to reduce GDM risks or delay onset of type 2 diabetes.

• Implement and expand the National Gestational Diabetes Register

service in Queensland to prompt post-pregnancy screening. References

(1) Sterne, VL., Logan T., Palmer MA. Factors affecting attendance at postpartum diabetes screening. Practical Diabetes International. 28(2): 64-68a (2011)

Challenges in GDM Care

You2 Program Aims

You2 Website

GDM Indigenous Resources

Newsletters

Multilingual Consumer Resource

GDM Peer Support Program

Screening Reminders

‘You2‘ Assisting women from diagnosis to post pregnancy

You2 – A Multi-Strategy Approach

The You2 program used multiple strategies to inform, empower and

support women through the GDM journey.

You2 Website (www.you2.org.au)

A website was designed to

enable women to:

• Access the latest information

on GDM management.

• Use an interactive pathway

to navigate the health system.

• Share experiences and

discuss concerns on a

moderated forum.

You2 Newsletters

Quarterly newsletters were distributed to

You2 website users and with screening

reminder letters.

Newsletters provided information on:

• Managing GDM

• Engaging with healthcare professionals

• Adapting/maintaining healthy lifestyle

behaviours during and after pregnancy

e.g. family-friendly recipes, increasing

physical activity, etc

Targeted Consumer Resources

GDM Indigenous Resources

•Indigenous communities were

consulted to revise culturally specific

resources.

• Pictorial representation was

used to overcome potential

barriers of low-literacy.

Multilingual GDM Consumer

Resource

Translated resources designed to

assist women in high-risk CALD

communities navigate the health

system and GDM management.

GDM Peer Support Program

(“You2Connect”)

• A novel GDM telephone peer support pilot program was

developed

• You2Connect enables newly diagnosed women to receive

experiential telephone support from trained volunteers

• Up to 5 calls are made during pregnancy to offer

reassurance, support and encouragement to adhere to

medical advice

• One call is made post-pregnancy to encourage participants

to have postnatal screening.

Post-Pregnancy Interventions

The You2 program implemented and expanded the services of

the National Gestational Diabetes Register in Queensland by:

• Providing registrants with NDSS resources at diagnosis

• Posting registrant post-pregnancy screening reminder letters

• Sending registrant SMS text reminders

• Posting screening reminder letters to registrants’ GP’s:

(Letters were posted two weeks prior to registrant letters to mitigate

risks of unexpected pregnancy outcomes).

Outcomes of the You2 Program

The high number of website visits and positive responses to SMS

screening reminders indicates consumer need for timely access to

interactive information.

Ongoing requests for all resources (particularly Indigenous and CALD

specific) indicated that a consumer gap in this area was met.

All You2Connect participants attended postnatal screening and valued

the emotional support received, validating peer support in diabetes care.

Positive feedback from health professionals to screening reminder letters

and consumer resources demonstrated a need for these interventions.

Implications

Pregnancy can be a ‘teachable moment’. GDM interventions commencing at

diagnosis and continuing post-pregnancy provide opportunities to:

Alleviate anxiety and improve coping behaviours.

Increase engagement with health professionals and confidence to self-

manage GDM.

Raise awareness of risks and facilitate healthy lifestyle behaviours.

Encourage post-pregnancy screening.

Long-term implications include reducing GDM related pregnancy complications

and delayed onset of type 2 diabetes or associated co-morbidities.

Acknowledgments The authors gratefully acknowledge contributions from these collaborators in program development and implementation:

Ms Kirsty McDougall Ms Rebecca O’Hara Queensland Health Cairns Diabetes Centre