Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

Diabetes Research and Clinical Practice
J KleinL J Maple-Brown

Abstract

Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews. Practitioners reported low attendance for preconception care however, 51% provided counselling on an opportunistic basis. Rural/remote practitioners were most likely to find counselling feasible. The majority (69%) utilised appropriate guidelines and addressed lifestyle modifications including smoking (81%), weight management (79%), and change medications appropriately such as ceasing ACE inhibitors (69%). Fewer (40%) prescribed the recommended dose of folate (5mg) or felt comfortable recommending delaying pregnancy to achieve optimal preconception glucose control (42%). Themes identified as barriers to care included the complexity of care setting and infrequent preconception consultations. There was a focus on motivation of women to make informed choices about co...Continue Reading

Citations

Oct 3, 2018·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Renae KirkhamLouise Maple-Brown
Nov 1, 2018·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Elizabeth A McCarthyAlexis Shub
Jan 26, 2020·International Journal of Environmental Research and Public Health·Anna WoodLouise Maple-Brown
Nov 13, 2019·African Journal of Primary Health Care & Family Medicine·Winifred C Ukoha, Makhosi Dube
May 28, 2020·International Journal of Environmental Research and Public Health·Emma GriffithsDavid Atkinson
Oct 30, 2019·BMC Pregnancy and Childbirth·R KirkhamUNKNOWN NT Diabetes in Pregnancy Partnership
Oct 28, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Angela L MagdalenoMarc A Vengrove
Jan 23, 2021·Clinical Obstetrics and Gynecology·Whitney Bender, Celeste Durnwald

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