Recommended changes to diagnostic criteria for gestational diabetes: Impact on workload
Recommended changes to diagnostic criteria for gestational diabetes: Impact on workload
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DOI：
10.1111/j.1479-828x.2010.01218.x
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发表时间：
2010-10-01
影响因子：
1.7
通讯作者：
McElduff, Aidan
中科院分区：
文献类型：
--
作者：
Flack, Jeff R.;Ross, Glynis P.;McElduff, Aidan
背景：妊娠期糖尿病（GDM）被认为是妊娠期的一个重要问题。根据高血糖和不良妊娠结局（HAPO）研究的数据分析，提出了对GDM诊断标准的修改。我们试图评估如果采用这些变化对澳大利亚GDM管理工作量的影响。目的：评估如果澳大利亚采用新推荐的诊断标准，对卫生专业人员工作量的影响，特别是对将被诊断为GDM的额外妇女人数的管理。方法：我们分析了在悉尼西南部和北部两家大型病理服务机构进行的孕妇口服葡萄糖耐量试验结果。我们使用现行的澳大利亚妊娠糖尿病协会（ADIPS）澳大利亚标准和拟议的新标准计算GDM率。结果：这些工作量数据比较了ADIPS和建议的国际糖尿病和妊娠研究小组协会标准。在两个时间段内检查的高危人群中，工作量估计增加了29.0%（基于2005年11月至2007年8月的数据）和31.9%（基于2007年9月至2009年8月的数据）。来自北悉尼的数据表明工作量增加了21.7%（基于1998年9月至2009年7月的数据）。结论：如果对GDM诊断标准的新建议变更在澳大利亚实施，我们可能需要改变我们目前管理GDM的服务结构，以应对需要管理的女性数量显著增加所带来的工作量影响。在某些单位，这种变化将是实质性的。
Background:Gestational diabetes mellitus (GDM) is recognised as a significant problem in pregnancy. Changes to GDM diagnostic criteria have been proposed following analysis of data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. We sought to assess the impact on the workload for GDM management in Australia that would occur if these changes were adopted.Aim:To assess the impact on health professional workload, specifically management of the number of additional women who would be diagnosed with GDM, should the newly recommended diagnostic criteria be adopted in Australia.Methods:We analysed oral glucose tolerance test results undertaken in pregnant women at two large pathology services in South West and Northern Sydney. We calculated GDM rates using current Australasian Diabetes in Pregnancy Society (ADIPS) Australian Criteria and the rates using the proposed new criteria.Results:These workload data compare ADIPS and proposed International Association of Diabetes and Pregnancy Study Groups Criteria. In a high-risk population examined in two time periods, the estimated increase in workload was 29.0% (based on November 2005 to August 2007 data) and 31.9% (based on September 2007 to August 2009 data). Data from Northern Sydney indicated a 21.7% increased workload (based on September 1998 to July 2009 data).Conclusions:If the newly recommended changes to the diagnostic criteria for GDM are implemented in Australia, we may need to change the way we currently structure our services to manage GDM, to cope with the workload impact of the significantly increased number of women who would require management. In some units this change will be substantial.