Diabetes research and clinical practice 2018 03 29() pii S0168-8227(17)31774-6
To assess the effectiveness of Initial Group versus Initial Individual GDM dietary education in terms of insulin requirements and pregnancy outcomes.
A retrospective audit of clinical data was conducted where English speaking women who received initial education in a group setting (01-2-2012 to 01-2-2014) (Group), were compared to women who received initial individual education with a dietitian (1-2-2010 to 31-1-2012) (Individual), all followed by one individual dietitian appointment. The same dietary information was provided in both settings. Data collected included: attendance rates, insulin requirements, maternal weight gain, and rates of adverse birth outcomes. Data were compared by t-test or Chi-squared test. Multivariable logistic regression analysis was conducted to determine independent predictors of insulin therapy.
Of 743 women; (362 Group and 381 Individual), Group women had a lower HbA1c at GDM diagnosis 5.3±0.6% versus 5.5±0.5% (34±6.6 mmol/mol versus 37±5.5 mmol/mol p<0.0001). There were no other differences in baseline characteristics. More Group women required insulin (42.0% versus 34.6%, p=0.048). Group education was found to be an independent predictor of insulin therapy (OR=1.9 [1.29, 2.75] p<0.001). CONCLUSIONS
Despite adjusting for all known potential confounders, unlike Individual education, Group education remained a significant predictor of insulin therapy (but resulted in similar therapeutic and pregnancy outcomes to Individual education).