Readiness for behaviour change after gestational diabetes mellitus: A prospective cohort study.

Aims: Women with gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes (T2D). Readiness for behaviour change to mitigate this risk may be low after pregnancy and may further decrease over time without appropriate interventions. This study aimed to evaluate readiness for behaviour change in the first and second postpartum years in women with recent GDM to determine the best timing for lifestyle interventions to prevent T2D.

The Canadian Hypoglycemia During Hospitalization Score Is Externally Valid in the Australian Diabetes IN-hospital: Glucose & Outcomes (DINGO) Cohort.

Objectives: The Hypoglycemia During Hospitalization (HyDHo) score predicts hypoglycemia in a population of Canadian inpatients by assigning various weightings to 5 key clinical criteria known at the time of admission, in particular age, recent presentation to an emergency department, insulin use, use of oral hypoglycemic agents, and chronic kidney disease. Our aim in this study was to externally validate the HyDHo score by applying this risk calculator to an Australian population of inpatients with diabetes.

Methods: This study was a retrospective data analysis of a subset of the Diabetes IN-hospital: Glucose & Outcomes (DINGO) cohort.

Service use and glycaemic control of young people with type 1 diabetes transitioning from paediatric to adult care: a 5-year study.

Background: Regular contact with specialist care has been linked to better diabetes outcomes for young people with type 1 diabetes (YPwT1D), but evidence is limited to population-based service usage and outcomes.

Aims: This observational 5-year study sought to capture YPwT1D living in the study catchment area (covering metropolitan, regional and rural Australia) as they transitioned to adult-based diabetes healthcare services and to describe their glycaemic control and complication rates, service usage and associated factors.

Methods: Records between 2010 and 2014 in a public healthcare specialist diabetes database were extracted, care processes and outcomes were described, and associations were sought between episodes of care (EOC) and potentially predictive variables.

Coexisiting type 1 diabetes and celiac disease is associated with lower Hba1c when compared to type 1 diabetes alone: data from the Australasian Diabetes Data Network (ADDN) registry.

Aim: To compare HbA1c and clinical outcomes in adolescents and young adults with type 1 diabetes (T1D), with or without celiac disease (CD).

Methods: Longitudinal data were extracted from ADDN, a prospective clinical diabetes registry. Inclusion criteria were T1D (with or without CD), ≥ 1 HbA1c measurement, age 16-25 years and diabetes duration ≥ 1 year at last measurement.

Blood pressure in adolescents and young adults with type 1 diabetes: data from the Australasian Diabetes Data Network registry.

Aim: Hypertension increases complication risk in type 1 diabetes (T1D). We examined blood pressure (BP) in adolescents and young adults with T1D from the Australasian Diabetes Data Network, a prospective clinical diabetes registry in Australia and New Zealand.

Methods: This was a longitudinal study of prospectively collected registry data.

Comparing IADPSG and NICE Diagnostic Criteria for GDM in Predicting Adverse Pregnancy Outcomes.

Objective: To compare the performance of diagnostic criteria for gestational diabetes mellitus (GDM) proposed by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) with those endorsed by the National Institute for Health and Care Excellence (NICE) in predicting adverse pregnancy outcomes.

Research Design And Methods: We performed a secondary data analysis of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study participants in five study centers. Logistic regression analyses were performed, and Akaike information criterion were applied for the comparison of different statistical prediction models.

Hospital presentations with diabetic ketoacidosis: A retrospective review.

Background: Diabetic ketoacidosis (DKA) is a significant source of preventable episodes of care and cost. This study aimed to describe the demographic and clinical characteristics of people with type 1 diabetes (T1D) presenting to the Emergency Department (ED) with DKA in an area of socio-economic deprivation in metropolitan Queensland, Australia, and to describe factors associated with hospital admission and re-presentation in this population.

Methods: This was a retrospective descriptive analysis of routine healthcare record data for January 2015-December 2019.

Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry.

Background: Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia.

Research Design And Methods: Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry.

Web-Based Questionnaire for Healthcare Professionals on Psychosocial Support for Adolescents and Young Adults with Type 1 Diabetes.

Introduction: Adolescence and young adulthood is a challenging period, particularly for those living with chronic disease such as type 1 diabetes (T1D). Effective professional support is associated with better diabetes outcomes, but little is known about what determines healthcare professionals' decision-making for therapeutic intervention, and how to support this. Our study aimed to determine healthcare professionals' (HCPs) self-rated awareness, capability, opportunity and motivation to provide support for psychosocial issues in the management of T1D with adolescents and young adults; and to identify factors independently predictive of HCPs' perceptions of their confidence in, and perceived importance of, addressing psychosocial issues in this population.

Prediction of large-for-gestational age infants in relation to hyperglycemia in pregnancy - A comparison of statistical models.

Aims: Using data from a large multi-centre cohort, we aimed to create a risk prediction model for large-for-gestational age (LGA) infants, using both logistic regression and naïve Bayes approaches, and compare the utility of these two approaches.

Methods: We have compared the two techniques underpinning machine learning: logistic regression (LR) and naïve Bayes (NB) in terms of their ability to predict large-for-gestational age (LGA) infants. Using data from five centres involved in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, we developed LR and NB models and compared the predictive ability and stability between the models.

Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?

Background: Diabetic ketoacidosis causes a significant number of hospitalisations worldwide, with rates tending to increase with remoteness and socioeconomic disadvantage. Our study aimed to explore healthcare professionals' perceptions of factors affecting presentation of people with type 1 diabetes in a low socioeconomic area of Queensland, Australia.

Methods: This was a qualitative study.

Role of maternal glucose metabolism in the association between maternal BMI and neonatal size and adiposity.

Background/objective: One potential mechanism by which maternal obesity impacts fetal growth is through hyperglycemia below the threshold for gestational diabetes. Data regarding which measures of maternal glucose metabolism mediate this association is sparse. The objectives of this study were to (i) quantify the associations of maternal pre-pregnancy body mass index (BMI) with neonatal size and adiposity and (ii) examine the role of markers of maternal glucose metabolism as mediators in these associations.

Do variations in insulin sensitivity and insulin secretion in pregnancy predict differences in obstetric and neonatal outcomes?

Aims/hypothesis: Gestational diabetes mellitus (GDM) is generally defined based on glycaemia during an OGTT, but aetiologically includes women with defects in insulin secretion, insulin sensitivity or a combination of both. In this observational study, we aimed to determine if underlying pathophysiological defects evaluated as continuous variables predict the risk of important obstetric and neonatal outcomes better than the previously used dichotomised or categorical approaches.

Methods: Using data from blinded OGTTs at mean gestational week 28 from five Hyperglycemia and Adverse Pregnancy Outcome study centres, we estimated insulin secretion (Stumvoll first phase) and sensitivity (Matsuda index) and their product (oral disposition index [DI]) in 6337 untreated women (1090 [17.

A discussion of healthcare support for adolescents and young adults with long-term conditions: Current policy and practice and future opportunities.

Background: Adolescence and young adulthood can be a period of significant and unique life changes in which competing demands and challenges distract from disease self-management. Specific challenges related to the way individual services are configured can also limit the support available. This paper presents a discussion of healthcare service support for adolescents and young adults, using type 1 diabetes as an exemplar.

Testing for gestational diabetes during the COVID-19 pandemic. An evaluation of proposed protocols for the United Kingdom, Canada and Australia.

Aims: We assessed how altered diagnostic processes and criteria for gestational diabetes mellitus (GDM) recommended by the United Kingdom (UK), Canada and Australia for use during the COVID-19 pandemic would affect both GDM frequency and related adverse outcomes.

Methods: Secondary analysis of 5974 HAPO study women with singleton pregnancies who underwent 75 g OGTTs and HbA1c assays between 24 and 32 weeks' gestation and who received no treatment for GDM.

Results: All post COVID-19 modified pathways reduced GDM frequency - UK (81%), Canada (82%) and Australia (25%).

Interaction between sex and rurality on the prevalence of diabetes in Guyana: a nationally representative study.

Introduction: Diabetes prevalence has never been measured in Guyana. We conducted a nationally representative cross-sectional study to estimate the prevalence of diabetes and pre-diabetes, and the association between sex and diabetes.

Research Design And Methods: In 2016, the Ministry of Public Health led Guyana's first national STEPS survey among adults aged 18-69 years.

Service use of young people with Type 1 diabetes after transition from paediatric to adult-based diabetes health care.

Objective The aim of this study was to determine, in the first 2 years after the last planned appointment with paediatric diabetes services for young people with Type 1 diabetes (T1D): (1) the number of planned and unplanned healthcare contacts and HbA1c measurements made; (2) factors linked to diabetes-related service use; and (3) factors predictive of the number of planned and unplanned service contacts, and of meeting the minimum number of planned service contacts. Methods Healthcare records of a major public healthcare provider in Australia were audited for preventive and acute service use by young people with T1D transferring from paediatric to adult public healthcare services. Statistical analyses included use of t-tests and logistic regression modelling.

Exploring women's priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury.

Background: There is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes.

Development and Validation of a New Diabetes Risk Score in Guyana.

Introduction: We present a new diabetes risk score developed and validated in a multi-ethnic population in Guyana, South America. Measurement of in-country diabetes prevalence is a vital epidemiologic tool to combat the pandemic. It is believed that for every person diagnosed with type 2 diabetes there is another undiagnosed.

Characteristics of Women With Gestational Diabetes From Non-Caucasian Compared With Caucasian Ethnic Groups.

Objectives: Short- and long-term outcomes in women after gestational diabetes mellitus (GDM) vary by ethnicity. Understanding differences in baseline diabetes risk factors is important for informing choice of risk-reducing interventions. We aimed to compare maternal and pregnancy-related characteristics in Caucasian and non-Caucasian women with GDM.

Implementation and Evaluation of the "Metformin First" Protocol for Management of Gestational Diabetes.

Objectives: Although metformin has traditionally been avoided in pregnancy, evidence now supports its safety and efficacy for management of gestational diabetes mellitus (GDM). The primary objective of this study was to evaluate the clinical impact of a metformin-based approach for GDM management through assessment of pregnancy outcomes, clinic efficiency and patient satisfaction.

Methods: A retrospective chart review was conducted of new GDM patients seen before (January to July 2015) and after (January to September 2016) implementation of the "Metformin First" (MF) protocol.