Cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: application of the GeDiForCE model in Australia

Beilby, Hannah; Yang, Fan; Gannon, Brenda; McIntyre, H. David

doi:10.1080/14767058.2021.1973415

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…However, this is unclear as although the Medicare Benefits schedule cost of the OGTT is $19.90 AUD, this is unlikely to reflect the true cost of the test in terms of personnel time involved three blood draws and facilities for patient to wait for 2 h [ 29 ]. Regardless, if CGM was shown to be better reflective of women’s glycaemic status than OGTT (i.e., fewer false positives and negatives), it would become cost-saving, given the recent findings of Beilby of costs of almost $6,000 AUD per ante/postnatal care in case of GDM diagnosis (false positive) and over $5,500 per perinatal adverse events in case of not intervention (false negative) [ 30 ]. When considering the OGTT/CGM prices and the economic consequences of potential GDM misdiagnosis, the increased cost of CGM appears justified by the potential prospective saving in antenatal and postnatal care.…”

Section: Discussionmentioning

confidence: 99%

Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals

Filippo

Darling

Chang

et al. 2023

Arch Gynecol Obstet

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Aims The oral glucose tolerance test (OGTT), used for gestational diabetes mellitus (GDM) diagnosis for over 65 years, has poor acceptability and tolerability. Continuous glucose monitoring is being considered as potential alternative. The aim of our study was to formally assess women’s and health care professionals’ perception of both tests as diagnostic tools for GDM. Methods Participants in a pilot study on continuous glucose monitoring for GDM diagnosis were invited to fill two questionnaires, each of 6 Likert-scale and one optional open-ended question. A range of healthcare practitioners were also invited to fill a questionnaire of 13 Likert-scale and 7 optional open-ended questions. Results Sixty women completed the OGTT and 70 the continuous glucose monitoring questionnaire. OGTT was reported as poorly acceptable. Continuous glucose monitoring was described as significantly more tolerable (81% vs 27% 5/5 general acceptability rate, p < 0.001); ninety-three percent of the participants would recommend it for GDM diagnosis. Thirty health care professionals completed the survey. Most of them (73%) had confidence in OGTT as a diagnostic test for GDM with 66% raising some concerns. Doubts on continuous glucose monitoring were raised in terms of costs, accessibility and accuracy for GDM diagnosis due to “lack of evidence”. Conclusions Continuous glucose monitoring was substantially better tolerated for women than OGTT. Current lack of evidence for diagnostic accuracy for GDM underlines the need for studies on correlation between continuous glucose monitoring parameters and pregnancy outcomes to strengthen evidence for its use as diagnostic test for GDM.

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Section: Discussionmentioning

confidence: 99%

Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals

Filippo

Darling

Chang

et al. 2023

Arch Gynecol Obstet

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“…The majority of these cases subside after delivery, but unfortunately, some of these women will suffer from T2D or other forms of glucose intolerance after successive deliveries [ 31 ]. Solid statistics document that 70% of women with gestational diabetes are at a high risk of developing diabetes (mainly T2D) later in their lives [ 33 , 34 ]. Therefore, antenatal care should not be neglected among pregnant women, especially in societies of the developing world where physical activity is almost non-existent among women in such populations.…”

Section: Metabolic Syndromementioning

confidence: 99%

A Glimpse into Milestones of Insulin Resistance and an Updated Review of Its Management

et al. 2023

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Insulin is the main metabolic regulator of fuel molecules in the diet, such as carbohydrates, lipids, and proteins. It does so by facilitating glucose influx from the circulation into the liver, adipose tissue, and skeletal myocytes. The outcome of which is subjected to glycogenesis in skeletal muscle and lipogenesis in adipose tissue, as well as in the liver. Therefore, insulin has an anabolic action while, on the contrary, hypoinsulinemia promotes the reverse process. Protein breakdown in myocytes is also encountered during the late stages of diabetes mellitus. The balance of the blood glucose level in physiological conditions is maintained by virtue of the interactive functions of insulin and glucagon. In insulin resistance (IR), the balance is disturbed because glucose transporters (GLUTs) of cell membranes fail to respond to this peptide hormone, meaning that glucose molecules cannot be internalized into the cells, the consequence of which is hyperglycemia. To develop the full state of diabetes mellitus, IR should be associated with the impairment of insulin release from beta-cells of the pancreas. Periodic screening of individuals of high risk, such as those with obesity, hypercholesterolemia, and pregnant nulliparous women in antenatal control, is vital, as these are important checkpoints to detect cases of insulin resistance. This is pivotal as IR can be reversed, provided it is detected in its early stages, through healthy dietary habits, regular exercise, and the use of hypoglycemic agents. In this review, we discuss the pathophysiology, etiology, diagnosis, preventive methods, and management of IR in brief.

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Integrated care of diabetes during pregnancy: a Qatari nationwide cohort

Bashir,

Ibrahim,

Beer

et al. 2024

eClinicalMedicine

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Cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: application of the GeDiForCE model in Australia

Cited by 4 publications

References 19 publications

Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals

Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals

A Glimpse into Milestones of Insulin Resistance and an Updated Review of Its Management

Integrated care of diabetes during pregnancy: a Qatari nationwide cohort

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