October 1, 2018Dr Amanda Quattrocelli is an Obstetrics and Gynaecology resident in the maternity department at Northern Health. Working with women treated at Northern, she has been researching gestational diabetes and has looked at early glucose tolerance tests and whether they are making a difference in the outcomes of our mothers and their babies.
She explains that gestational diabetes, a type of diabetes women may develop during pregnancy, should go away after pregnancy although it is well known that if women have diabetes in pregnancy, they are at a increased risk of developing overt type 2 diabetes later in life.
“We look at it as an early warning sign”, she said.
Dr Quattrocelli has done two separate studies comparing women who have early glucose tolerance tests compared to later or normal timed tests and their outcomes. A follow-up study was also conducted with the aim to determine the strongest predictors of an early diagnosis of gestational diabetes.
“The results of the studies have shown that if women who had an early diagnosis of GDM were more likely to be insulin dependent by the time of delivery, and if they had a late diagnosis of gestational diabetes they were more likely to have a spontaneous onset of labour and be diet controled at the time of delivery,” she said.
For all other outcomes, in terms of maternal outcomes, birth trauma, birth statistics and foetal outcomes, there were no differences between women who had early glucose tolerance testing and ones who were diagnosed later.
The follow-up study looked at all the women who had early glucose tests and what their risk factors were, and found the strongest predictors for gestational diabetes were a family history of diabetes or having gestational diabetes in a previous pregnancy.
“A lot of our women are from many different ethnic backgrounds and lots of them have an increased BMI which are risk factors for GDM and I was surprised that many of our women had early tolerance tests, but not necessarily had an early GDM diagnosis,” Amanda said.
This led to Dr Quattrocelli creating a flow chart, helping to better analyse women with risk factors for GDM in our antenatal clinics, which is a possibility in the future management of our pregnant women, but that more research is needed before we can implement any change in clinics.
“Northern has been very supportive in my research – I am seeing a lot of improvements when it comes to research. Hiring a statistician is very helpful and that would have helped me a lot when I was doing my research. Northern Health is up and coming with its research and taking steps in the right direction,” she said.
Research weeks runs at Northern Health from 8 – 12 October.
