Colorado Collaboration on Gestational Diabetes Guidelines Diabetes and Women s Health Conference November 4, 2011

Colorado Collaboration on Gestational Diabetes Guidelines Diabetes and Women s Health Conference November 4, 2011 Colorado Department of Public Health and Environment (CDPHE) Prevention Services Division

Collaborative Partners GDM Work Group HealthTeamWorks (formerly Colorado Clinical Guidelines Collaborative) Community Health Association of Mountain/ Plains States (CHAMPS) Women s Health Unit at CDPHE University of Colorado, Denver, Division of Endocrinology, Metabolism, and Diabetes Colorado State University, Dietetics Program, Student Interns

Public Health System Improvement Physician Advocate Dr. Linda Barbour GDM Guidelines (short and long forms) Physician Webcasts GDM Nutrition Guidelines Regional Trainings Addendum to GDM Guidelines

Colorado GDM Prevalence Overall Prevalence 7.7% 14% GDM by Race/Ethnicity 12% 10% 8% 6% 4% 2% 0% White/Non-Hispanic Hispanic Black Other Source: CDPHE, Health Statistics Section, PRAM 2009

GDM Prevalence GDM by Body Weight 16% 14% 12% 10% 8% 6% 4% 2% 0% Underweight Normal Weight Overweight Obese Source: CDPHE, Health Statistics Section, PRAM 2009

Physician Champion Linda Barbour, MD, MSPH Associate Professor in Endocrinology and Maternal-Fetal Medicine at the University of Colorado Health Sciences Center Presented webcast on current recommendations Advisor to guideline development Consultant for trainings and technical consultant Promoted Colorado GDM guidelines

Webinar: Gestational Diabetes: New Concepts, New Guidelines Provided 2 free webinars in February & March 2007 101 active participants, 20 online archive participants Provided findings from trials recommendations from the 5 th International Workshop on Gestational Diabetes Offered 1.5 Continuing Medical Education through March 2008 - $15

Clinical and Nutrition Guidelines for GDM Objective: Increase knowledge of standard of care for GDM Distributed to physicians, midwives, community health workers

GDM Guideline Recommendations Early screening and education for high-risk women Universal screening Follow-up glucose test at 6-week postpartum visit Identify high risk for type 2 diabetes Recommend lifestyle intervention

Regional On-Site Trainings Review GDM Guidelines Relate Guidelines to GDM practice Recognize challenges and barriers to care Identify educational resources/tools Understand long term risk of GDM for mother/child Encourage communication between GDM provider and educator

Regional Trainings 8 regional trainings 254 participants

GDM Self-Study Webinars Total certificates: 172 2009: 53 2010: 95 2011 (through April 30): 24 80% 70% 60% 50% 40% 30% 20% 10% GDM Guidelines Job Position of Certificate Recipients 0% Diabetes Educator Registered Dietitian Community Health Worker WIC nutrition educator Public health nurse Medical office staff

GDM Self-Study Webinars Total certificates: 138 2009: 41 2010: 70 2011 (through April 30): 27 80% 70% 60% 50% 40% 30% 20% 10% GDM Nutrition Job Position of Certificate Recipients 0% Diabetes Educator Registered Dietitian WIC nutrition educator Public health nurse Nurse practitioner Medical office staff

GDM Materials Available through PSD Fulfillment Center www.cohealthresources.org

External Partner Website HealthTeamWorks http://www.healthteamworks.org/guidelines/gestational-diabetes.html

Internal Partner Website Women s Health Unit http://www.cdphe.state.co.us/pp/womens/gestationaldiabetes.html

Challenges Facilitating health system change Medical care for GDM in rural areas Consistent standards of care

Lessons Learned Physician champion integral to success Statewide GDM guidelines provides consistent message Multiple methods of distribution facilitated broad reach to providers

THANK YOU! Michelle Hansen, Michelle.Hansen@state.co.us Phone 303-692-2577 Mandy Bakulski, Mandy.Bakulski@state.co.us