National Women's Annual Clinical Report 2010
National Women's Annual Clinical Report 2010
National Women's Annual Clinical Report 2010
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5.4 Diabetes<br />
Methods<br />
The data in this section relate to women with a diagnosis of pre-existing or gestational<br />
diabetes who birthed at <strong>National</strong> Women’s in <strong>2010</strong>. It includes women who were cared for<br />
solely by the <strong>National</strong> Women’s Diabetes Clinic, women with some input from the<br />
Diabetes Clinic while under the care of non-Diabetes Clinic LMC, and women with no<br />
Diabetes Clinic input. It does not include women cared for by the Diabetes Clinic who<br />
birthed prior to 20 weeks or who birthed elsewhere.<br />
Findings<br />
In addition to these data the diabetes service had 56 referrals for pre-pregnancy<br />
counselling. We saw 38 of the pre-pregnancy referrals, but 18 remain unseen because we<br />
have not had the capacity to review them. Also 30 other women were booked into clinic<br />
but their data are not shown as they either miscarried or transferred elsewhere for<br />
birthing.<br />
The ongoing rise in women with GDM probably reflects an increased uptake of testing for<br />
GDM plus the change in population demographics with increased rates of obesity and<br />
type 2 diabetes at younger ages.<br />
Last year we commented that new international guidelines for testing for diabetes in<br />
pregnancy had been published, which would lead to more women being diagnosed with<br />
GDM, as the recommendations had a lower glucose cut off for the diagnosis of GDM than<br />
current NZ criteria. In Auckland, we have not changed to the new criteria, as we are<br />
struggling to provide adequate care for women who are diagnosed by our current criteria.<br />
We have continued to work on developing models of care so that some women can be<br />
cared for in community clinics in the future. Education and training of clinicians to provide<br />
this care is a priority. Hopefully, we can then have discussions about whether to adopt the<br />
new criteria over the next 12 months.<br />
GDM<br />
8.0<br />
7.0<br />
6.0<br />
5.0<br />
4.0<br />
3.0<br />
2.0<br />
1.0<br />
0.0<br />
GDM Type I Type 2<br />
1991<br />
1992<br />
1993<br />
1994<br />
1995<br />
1996<br />
1997<br />
1998<br />
1999<br />
2000<br />
2001<br />
2002<br />
2003<br />
2004<br />
2005<br />
2006<br />
2007<br />
2008<br />
2009<br />
<strong>2010</strong><br />
Figure 25: Incidence of diabetes (% of all inborn and BBA births) (1991-<strong>2010</strong>)<br />
56<br />
2.0<br />
1.8<br />
1.6<br />
1.4<br />
1.2<br />
1.0<br />
0.8<br />
0.6<br />
0.4<br />
0.2<br />
0.0<br />
Type 1<br />
and 2
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