Gestational Diabetes Mellitus (GDM) is a condition which can lead to increased risk of complications during pregnancy resulting in higher risk of maternal and perinatal morbidity and mortality. GDM does not only affect the mother and child during pregnancy and birth, it also increases the mothers’ risk of developing diabetes later in life and it increases the child’s risk of becoming obese, developing hypertension and diabetes.The Peking University First Hospital has commenced this project to improve the access to gestational diabetes care services with the aim of preventing complications during pregnancy, at birth and future prevention of diabetes. Awareness, access to sufficient information, education of health care personnel and accessible treatment opportunities comprise the basis of this project.The main objective of the project is to screen, identify and provide care to women with GDM and thereby prevent severe morbidity and mortality. This will be achieved by providing access to adequate information on GDM in general, its risk factors and guarantee that screening, monitoring and treatment are available.
The project is implemented by the Peking University First Hospital and is the first WDF based project focusing on gestational diabetes in China.In the first phase of the project, five different cities in China will be selected as pilot sites: Beijing, Shanghai, Guangzhou, Tianjin and Shenyang. In each of these cities, three GDM centers will be established in hospitals that already attract women during pregnancy, totaling 15 centers established during the first year of the project.5 physicians (obstetricians or endocrinologists from each GDM center) will be trained as trainers for other health care personnel in other levels of the health care system. Members from the Chinese Diabetes Society and members from the Society of Perinatal Medicine will be in charge of the training sessions that last two days. The training is based on “Guidelines of GDM diagnosis and treatment” and involves topics like screening and diagnosis of GDM, treatment, monitoring and day to day self management of GDM. The newly trained trainers will educate other health care personnel in sessions of one and a half day.This approach will be repeated in the second and third year of the project and expand to five new cities each year adding up to 45 established centers and 4,500 trained health care professionals after three years.The project will initiate a “green channel” referral system, where hospitals with GDM centers will facilitate quick review and back referrals for patients referred for expert advice from other hospitals. China is working with three health care levels. When a woman at the first level is diagnosed with diabetes, she will not only be educated in diet and exercise, but now also be referred to treatment in hospitals in second and third level depending on the need. This will ensure quality of treatment and follow-up of the patients.Furthermore, the project aims at raising the public awareness about the risk factors and prevention of GDM as well as future prevention of diabetes. This will be reached by disseminating information at the GDM centers and also by conducting a survey. The survey will focus on the current understanding of GDM, its risk factors, and its prevention both among fertile women as well as among health care providers. It is believed that an increased knowledge of GDM will play an important role in the prevention and early detection of GDM.
• 45 GDM centers established• 1,394 clinics strengthened with GDM care• 297 GDM trainers trained• 19,745 health care professionals trained • 447,079 women at high risk educated • 352,021 women screened for GDM• 92,686 GDM patients were diagnosed and treated• Several surveys conducted• Green Channel referral model established