Projects

Education for women with hyperglycemia in pregnancy, WDF15-1314

WDF15-1314
Improving the diagnosis, quality of care and treatment of women with gestational diabetes (GDM).

Non-communicable diseases (NCDs) such as diabetes, obesity, hypertension and maternal health are closely linked. NCDs have a negative impact on the health both of the mother and the foetus. Epigenetic factors act during intrauterine programming, negatively affecting the health of future generations, setting up a vicious circle of vulnerability in children, increasing their risk of developing diabetes and cardiovascular disease in the future.

The prevalence of diabetes mellitus is 9.8% (survey from 2013) in the Argentinean population over 20 years og age, but the prevalence is greater in women of child-bearing age; 10.4%.

At the same time, there has been an alarming increase over the years 2005-2013 in the prevalence of overweight and obesity.  Among women of child-bearing age, the prevalence of obesity is currently 40.9%.

Officially, diabetes accounted for 1% of maternal deaths registered countrywide in 2013. But this is vastly under-recorded, since testing for it is still not universally applied. By testing, the incidence of congenital defects could be reduced, by controlling glycemic levels prior to conception and during the first three months of pregnancy.

 

Objectives

To improve diagnosis and care of women with gestational diabetes (GDM) in three suburban areas through health system capacity building and education.

 

Approach

The project seeks to implement a comprehensive approach to GDM in three suburban areas.

The target population is the group of pregnant women spontaneously attending maternity units in the city of Corrientes, the neighbourhood of La Boca (Autonomous City of Buenos Aires) and San Isidro (Province of Buenos Aires), and the health teams at participating primary care centres and maternity units.

These are the planned activities:

Establishment of GDM centres at one Ministry og Health (MoH) hospital maternity ward in each area including through sensitisation meetings with government officials.

Development of education material on GDM risk factors and diagnosis.

Capacity building of multidisciplinary health care professional (HCP) teams at hospital maternity wards and primary care centres within diagnosis and treatment of GDM.

Rollout of screening programme for GDM among pregnant women using the guidelines from the Latin American Diabetes Association, ALAD for diagnosis, detection and treatment.

Design of an electronic registry with clinical and therapeutic indicators.

Postpartum monitoring of mothers diagnosed with GDM to ensure healthy lifestyles and prevent the transition to Type 2 diabetes.

Education of women with GDM about care of GDM, prevention of future GDM, and prevention of diabetes for the children.


Expected results

  • Three GDM centers in three hospital maternity wards established
  • 50 obstetricians, 6 biochemists, 12 nurses and 12 administrators from three hospital maternity wards trained
  • 60 HCPs (including 15 gynaecologists) from 12 primary care centres trained
  • 100 posters and 15,000 brochures on GDM management distributed
  • 15,000 fasting blood glucose tests (first consultation) and 11,000 oral tolerance glucose tests (24-28 weeks) performed
  • 4,500 women with GDM (2,700 newly diagnosed and 1,800 previously diagnosed as control group) included in registry
  • 500 women with GDM enrolled in postpartum monitoring programme
  • 900 women with GDM enrolled in GDM education programme
  • Electronic monitoring system established and functioning with enrolment of all registered patients and with clinical indicators
     

Project information

Project nr.: 
WDF15-1314
Project Status: 
Ongoing
Interventions and focus areas: 
Primary focus area: 
Region: 
South and Central America
Country: 
Argentina
Partners: 
Facultad de Medicina (Faculty of Medicine), Universidad Nacional del Nordeste (National University of the Northeast)
Project responsible: 
Silvia Gorban de Lapertosa
Project period: 
2016 to 2019
Project budget: 
USD 794,100
WDF contribution: 
USD 250,000

Expected results

  • Three GDM centers in three hospital maternity wards established
  • 50 obstetricians, 6 biochemists, 12 nurses and 12 administrators from three hospital maternity wards trained
  • 60 HCPs (including 15 gynaecologists) from 12 primary care centres trained
  • 15,000 fasting blood glucose tests and 11,000 oral tolerance glucose tests performed
  • 500 women with GDM enrolled in postpartum monitoring programme and 900 women with GDM enrolled in GDM education programme

+ more