Can gestational diabetes education improve perinatal outcomes?

Abstract

Gestational diabetes, a glucose intolerance that appears during pregnancy, is associated with a high risk for both the mother and the fetus/baby to develop gestational and postpartum complications, obesity, and type 2 diabetes¹. Both maternal and infant morbidity and its negative socioeconomic impact can be significantly reduced through early diagnosis, incorporating therapeutic education as part of the treatment². For this reason, we have developed a structured, comprehensive, and multifactorial educational model "EduGest"³, whose main objective is to promote the joint action of primary care centers (CAPS) and maternity hospitals in Argentina to facilitate patients' access to early consultation, timely diagnosis, and appropriate treatment through the implementation of the program. This aims to provide knowledge that leads to the adoption of positive proactive attitudes by the health team members, educators, and pregnant women, thereby improving their quality of life and preventing long-term complications for both the mother and her offspring.

This is a prospective, controlled, and sequential study with a quantitative evaluation of results that allows: a) validating the diagnostic algorithm to be implemented, and b) defining the clinical, metabolic, therapeutic advantages, and cost-effectiveness of the educational model used.

To achieve the stated objectives, we have organized a recruitment network of pregnant women in 10 maternities across different Argentine provinces. In each location, awareness campaigns are conducted, disseminating information about gestational diabetes, its health impact, and educational kits are distributed for use in workshops.

Scheduled workshops are conducted in small group formats for pregnant women with gestational diabetes and their families, with tele-monitoring through ICTs to reinforce control and encourage postpartum consultation for their reclassification.

To date, 1,276 women with gestational diabetes have participated in the program, with a BMI of 31.4±6.6. Of these, 615 (48.2%) were reclassified, 19.5% compatible with prediabetes and 4.2% with type 2 diabetes. It is observed that with the educational intervention, there is a change in the nutritional pattern with a decrease in caloric intake without impacting the baby's weight, due to the reduction of refined sugars and saturated fats⁴.

Finally, EDUGEST aims to break the vicious cycle generated by gestational diabetes regarding future type 2 diabetes in the mother and child by promoting the adoption of healthy habits.