Oral Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Dietetic service provision for gestational diabetes mellitus in Australia: What has changed in 10 years? Findings comparing two national surveys. (#12)

Robyn A Barnes 1 2 , Melinda Morrison 3 4 , Jeff R Flack 2 5 6 , Glynis P Ross 2 7 , Carmel E Smart 1 8 , Clare E Collins 1 9 , Lesley MacDonald-Wicks 1 9
  1. School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle , NSW, Australia
  2. Diabetes Centre, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
  3. Diabetes NSW & ACT, Glebe, NSW, Australia
  4. Diabetes Australia, Canberra, ACT, Australia
  5. Faculty of Medicine, University of NSW, Sydney, NSW, Australia
  6. School of Medicine, Western Sydney University, Sydney, NSW, Australia
  7. Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
  8. Department of Paediatric Endocrinology and Diabetes, John Hunter Children’s Hospital, Newcastle, NSW, Australia
  9. Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Newcastle, NSW, Australia

Aims: Examine current Australian dietetic service provision for GDM by comparing findings to a previous survey1 and to the American Academy of Nutrition and Dietetics Nutrition Practice Guidelines2.  

Methods: A survey of dietitians providing Medical Nutrition Therapy to women with GDM in Australia was conducted in 20091 and repeated in 2019. This abstract compares responses to service provision questions.

Results: A total of 149 and 220 dietitians met inclusion criteria in the 2019 and 2009 surveys respectively. Not all questions were answered by all respondents. Most respondents reported that all women attending their service with GDM were referred to a dietitian in both 2019 and 2009 respectively (83% and 77%; NS). More respondents provided group education in 2019 versus 2009 (51% versus 33%; p<0.001). Fewer respondents indicated that women received only one dietetic intervention in 2019 compared to the 2009 survey (13% versus 31%; p<0.0001). Although less than a half of dietitians provided the minimum of three dietetic visits (including group education) stipulated in the guidelines2 in 2019, this was an increase compared to the 2009 survey (49% versus 33%; p<0.001). When respondents were asked to describe how their dietetic service is attempting to meet any increase in GDM clinical workload following uptake of the IADPSG GDM diagnostic criteria, the most common responses were: increased use of group education (25%); increased clinic time through reallocation of existing services (22%); increase in funded dietetic time (11%); and reduction or omission of individual review visits (7%). When asked whether their service provided adequate dietetic intervention for GDM, 42% in 2019 selected yes, down from 54% in 2009 (NS).

Conclusions: Dietetic service provision for GDM in Australia continues to fall short of evidence-based recommendations. Increased workload has necessitated changing models of care and made provision of adequate GDM dietetic interventions even more challenging.

1. Morrison MK, Collins CE and Lowe JM. Dietetic practice in the management of gestational diabetes Mellitus: A survey of Australian dietitians. Nutrition & Dietetics; 2011:68:189-194.

2. Duarte-Gardea MO, Gonzales-Pacheco DM, Reader DM, Thomas AM, Wang SR, Gregory RP, Piemonte TA, Thompson KL, Moloney L. Academy of Nutrition and Dietetics Gestational Diabetes Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet;2018:118(9):1719-1742.