Final presentation gdm 1

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  • 1. WOULD YOU…?Leave a baby with no escape?
  • 2. Cesarean UNCONTROLLED DIABETES  ADVERSE OUTCOMES Congenital heart defects Congenital heart defects Sirenomelia syndrome Sirenomelia syndrome Miscarriage Macrosomia Macrosomia Shoulder Dystocia Shoulder Dystocia Cesarean Miscarriage DEATH
  • 3. BARRIERS?
  • 4. WHAT PERCENT OF PREGNANCIES ARE UNINTENDED? • A: 80-85% • B: 70-75% • C: 20-45% • D:10-15% 9 18 23 11 17 22 Non-Hispanic White Hispanic Non-Hispanic Black Unwanted Mistimed 20% 35% 45% Adapted from: Mosher WD, Jones J, Abma JC. Intended and unintended births in the United States: 1982–2010. National health statistics reports; no 55. Hyattsville, MD: National Center for Health Statistics. 2012.
  • 5. WHAT ABOUT PLANNED PREGNANCIES? Uncontrolled Diabetes Nausea Obesity Cravings/A versions
  • 6. 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0 20.0 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 Pills only Insulin Only Both Insulin AND Pills Insulin or Pills No meds Adapted from: CDC Diabetes Data & Trends: Number (in Millions) of Adults with Diabetes by Diabetes Medication Status, United States, 1997–2011 (PREVALENCEINMILLIONS) DIABETES PREVALENCE (U.S.A)
  • 7. RISING PREVALENCE OF DIABETES CDC Estimate: By 2050, 1 in 3 adults will have diabetes, if current trends continue Diabetes Report Card 2012. Center for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation
  • 8. WHERE DOES THE PATIENT TURN?
  • 9. Kozhimannil KB, Abraham JM, Virnig BA. National trends in health insurance coverage of pregnant and reproductive-age women, 2000 to 2009. Womens Health Issues. 2012 Mar;22(2):e135-41. HAS HEALTHCARE GOTTEN BETTER FOR WOMEN? Uninsured within 1 year prior to study enrollment, 2 5% Uninsured if NOT pregnant, 19 % Uninsured if PREGNANT, 10% Insured, 46% 1.5 % per year over 10 years
  • 10. A BETTER WAY…
  • 11. FAMILY PLANNING PRECONCEPTIONAL COUNSELING EDUCATION
  • 12. PATHWAY TO PREGNANCY HgA1C GOAL!!!
  • 13. Glucose Testing Early Ultrasound Ophthalmalogic Screening Cardiac & Renal Evaluation PATHWAY TO PREGNANCY
  • 14. INCREASING AWARENESS Community Educators Student Groups Parents Doctors
  • 15. Grocery Chains Local Business
  • 16. WHAT’S NEEDED… PARTNERS
  • 17. THANK YOUQUESTIONS?