1223-P: Diabetes in Pregnancy in the Caribbean: A Systems Enablement Approach to Universal Access, Screening, and Treatment

Abstract

In Trinidad and Tobago there is a high background prevalence of diabetes in women of reproductive age and wide variability of screening practices for diabetes in pregnancy (DiP). A systems enablement approach was implemented to achieve national consensus on clinical guidelines and facilitate universal screening. A secure ICT solution (app) for real-time communication of blood glucose results was designed and piloted to standardize reporting systems and integrate services for pregnancy care. National consensus was achieved through consultations with healthcare professionals and followed up with training on the standardized guidelines for DIP and continuous medical education for over 300 in the field to improve adoption. The app facilitated a system of data capture, storage and retrieval among antenatal caregivers, patients and health administrators. The app is scalable and can integrate with other standards-based ICT health systems. The app was pilot tested and 658 pregnant women, 7 lab technologists and 24 doctors were trained registered users. All pregnant women registered on the app were screened using a standard 75g 2-hour OGTT after an overnight fast. Gestational diabetes prevalence was 14.1%. The high GDM prevalence justifies a need for systems change and universal screening for diabetes in pregnancy in Trinidad and Tobago. The app facilitates timely delivery of results to patient and healthcare provider. Training healthcare teams in diagnosis and management of diabetes in pregnancy using ICT simultaneously provides the platform to enhance patient self-management. Disclosure S. Teelucksingh: None. H. Chow: None. F.K. Lutchmansingh: None. S. Ramsewak: None.