Breaking the Cycle of Gestational Diabetes for a New Life
Around the world, 18 million women are affected by a medical condition that receives little attention as a public health priority: Gestational Diabetes Mellitus (GDM), a condition in which women without previously-diagnosed diabetes exhibit high blood glucose (blood sugar) levels during pregnancy. Left untreated, gestational diabetes can lead to devastating outcomes for mother and baby such as higher likelihood of preterm birth to increased risk of maternal morbidity and mortality. It is estimated that 15% of the total number of caesarean sections may be due to gestational diabetes.
This is why in 2011, The World Diabetes Foundation, Steno Diabetes Center, and Novo Nordisk decided it was time for a change. They launched Vida Nueva (New Life), a project in Barranquilla, Colombia to integrate GDM diagnosis and treatment into prenatal care for the city’s most vulnerable population.
Their first challenge was to figure out why GDM has remained a low priority on the public health agenda for so many years. What the project uncovered was a cycle of inaction including:
- Low awareness and prioritization of GDM
- Outdated standards of care
- Insufficient diagnosis and treatment
- Disempowered patients
- Scarce Data
Not only did the quality of GDM care vary greatly throughout Colombia, proper standards of care were not being followed and the lack of compelling data made it next to impossible to effect changes in public health priorities. There would need to be a significant shift in order to break this cycle of inaction. So Vida Nueva stepped up to the plate and launched a three-year project to address all the roadblocks. The ambitious agenda included:
- Build awareness
- Establish standards of care
- Increase quality of care
- Improve patient support
- Generate evidence
With the aid of local, national, and international stakeholders Vida Nueva has met or exceeded nearly all of its targets in only three years. Notably, they have raised the rate of GDM screenings from 5 percent to 97 percent, resulting in 21,169 women screened, and 1,853 diagnosed. A key medical expert observed, “Pregnant women see the benefit of Vida Nueva and are talking to each other about it. They are learning how to eat properly while preventing excessive weight gain and learning basic exercise routines.” Vida Nueva was also able to train more than 1,250 local health workers on the new GDM guidelines– which includes universal testing for hyperglycemia during pregnancy using a one-step procedure and practical nutrition counseling – ensuring that GDM focus is ingrained in medical practice.
Vida Nueva was created to launch action for GDM, and they did just that. The hope is that this model will now serve as inspiration for others seeking to tackle GDM in other regions of the world. For those interested in replicating their approach, Vida Nueva came up with Five Principles to Consider when Establishing a GDM Project:
- Universal screening is key
- Integrate GDM screening and care into maternal and child health services
- Engage community health workers
- Empower pregnant women
- Mobilize diverse stakeholders around a shared value proposition led by a strong local team
One of the most amazing things from the case study was the testimonials that came from the women who took part in Vida Nueva. One patient shared: “We have learned that we need to take care of our lives. Life is beautiful…and we want to keep moving forward.”
For more information on Vida Nueva, and to access the full case study please click here.