Normalization of Pregnancy Outcome in Pregestational Diabetes Through Functional Insulin Treatment and Modular Outpatient Education Adapted for Pregnancy

Howorka, Kinga; Pumprla, J.; Gabriel, Mario; Feiks, A.; Schlusche, C.; Nowotny, Ch.; Schobert, Earl E.; Waldhoer, Thomas; Langer, Martin

doi:10.1097/00006254-200208000-00003

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“…Thus, PGDM poses a significant healthcare and economic burden. As a result, there have been advancements in education 13,14 , technology 15,16 and pharmacology 17 to improve maternal and infant outcomes in women with PGDM.…”

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confidence: 99%

A core outcome set for the treatment of pregnant women with pregestational diabetes: an international consensus study

Kgosidialwa

Bogdanet

Egan

et al. 2021

BJOG

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To develop a core outcome set (COS) for randomised controlled trials (RCTs) evaluating the effectiveness of interventions for the treatment of pregnant women with pregestational diabetes mellitus (PGDM). DesignA consensus developmental study. SettingInternational. PopulationTwo hundred and five stakeholders completed the first round. MethodsThe study consisted of three components. 1) A systematic review of the literature to produce a list of outcomes reported in RCTs assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. 2) A three-round, online eDelphi survey to prioritise these outcomes by international stakeholders (including healthcare professionals, researchers and women with PGDM). 3) A consensus meeting where stakeholders from each group decided on the final COS. ResultsWe extracted 131 unique outcomes from 67 records meeting the full inclusion criteria. Of the 205 stakeholders who completed the first round, 174/205 (85%) and 165/174 (95%) completed round 2 and 3, respectively. Participants at the subsequent consensus meeting chose 19 outcomes for inclusion into the COS: trimester specific HbA1c, maternal weight gain during pregnancy, severe maternal hypoglycaemia, diabetic ketoacidosis, miscarriage, pregnancy induced hypertension, pre- Accepted ArticleThis article is protected by copyright. All rights reserved eclampsia, maternal death, birth weight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, mode of birth, shoulder dystocia, neonatal hypoglycaemia, congenital malformations, stillbirth and neonatal death. ConclusionsThis COS will enable better comparison between RCTs to produce robust evidence synthesis, improve trial reporting and optimise research efficiency in studies assessing treatment of pregnant women with PGDM.Tweetable abstract 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy * Outcome suggested by more than one participant in round 1.

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