Program Planning and Evaluation for the Treatment of Women with Gestational Diabetes (GDM) in Rural Northwest Washington

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Lungren, Amanda
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Public Health Science , Diabetes, Gestational , Glucose Tolerance Test , Breast Feeding
Gestational diabetes (GDM) is the most common metabolic disorder in pregnancy. The CDC estimates that up to ten percent of women in the United States experiences GDM. This health concern can be managed by both lifestyle changes and medications when needed. GDM can have serious health implications for both mother and baby. If not treated adequately, babies can be born nine pounds or more, which can result in injury to baby during delivery or increase the mother’s chances of cesarean birth with longer recovery time. Additionally, GDM increases chances of type two diabetes, a growing chronic disease, in both baby and the mother. Due to the rural nature of Fidalgo Island, there is limited access to diabetes specialty care, such as an endocrinologist in this area, leaving most of the diabetes management to the diabetes educator and family care provider or obstetrician (OB). The current Island Health (IH) GDM program has room for improvement. Currently, there are no official protocols for when or how to initiate medication management in these patients. Additionally, there are no classes before, during or after pregnancy specific to gestational diabetes management or prevention. Also, there is limited participant qualitative information gathered in the GDM program. Moreover, prior to this project there have not been any questionnaires, satisfaction surveys, focus groups, or process evaluations implemented to assess the program. After implementing a GDM program focus group, findings dictated clear recommendations for the program. The focus group indicated the need for more support and education prior to and after the current GDM program. Moreover, the focus group indicated the need for additional breastfeeding resources and support in completing postpartum oral glucose tolerance tests (OGTT). Though the focus group was small, findings were critical in implementing program changes to benefit the IH GDM program.