Overview
This study is a randomized controlled trial to study the effect of the use of a risk stratification screening tool for high- and low-risk gestational diabetes mellitus (GDM), and the implementation of a new low-impact care pathway for women with low-risk GDM. The study will measure how well the screening tool and new care pathway are used, and the effect of the new low-impact care pathway on glycemic control, perinatal outcomes (large for gestational age, rate of labor induction, mode of delivery, obstetric anal sphincter injury, neonatal hypoglycemia, neonatal anthropometry) and health resource utilization in women with GDM that are at low-risk of dietary therapy failure.
Eligibility
Inclusion Criteria:
- Women able to understand and sign the study consent form
- singleton pregnancy
- planning to give birth to at St. Michael's Hospital
- diagnosed with GDM between 24-32 weeks' gestation based on a positive GCT or GTT result as defined by the Canadian Diabetes Association Clinical Practice Guidelines
Exclusion Criteria:
- Women with preexisting diabetes (Type 1 or 2 diabetes)
- multiple gestation, or a diagnosis of GDM before 24 weeks' or after 32 weeks' gestation
- not continuing care at St. Michael's Hospital after the DIP clinic visit