Exploring women's priorities for the potential consequences of a gestational diabetes diagnosis: a pilot community jury

Thomas, Rae, Scott, Anna Mae, Sims, Rebecca, Craig, Louise, Claase, Leigh-Anne, Lowe, Julia, Heal, Clare, Hardiman, Leah, and Glasziou, Paul (2020) Exploring women's priorities for the potential consequences of a gestational diabetes diagnosis: a pilot community jury. Health Expectations. (In Press)

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Abstract

Background: There is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes. We explored the priorities and preferences of women potentially impacted by a GDM diagnosis.

Method: We recruited 15 women from the Gold Coast, Australia, to participate in a pilot community jury (CJ). Over two days, the women deliberated on the following: (a) which important consequences of a diagnosis of GDM should be considered when defining GDM?; (b) what should Australian health practitioners call the condition known as GDM?

Results: Eight women attended the pilot CJ, and their recommendations were a consensus. Women were surprised that the level of risk for physical harms was low but emotional harms were high. The final ranking of important consequences (high to low) was as follows: women's negative emotions; management burden of GDM; overmedicalized pregnancy; minimizing infant risks; improving lifestyle; and macrosomia. To describe the four different clinical states of GDM, the women chose three different labels. One was GDM.

Conclusions: The women from this pilot CJ prioritized the consequences of a diagnosis of GDM differently from clinicians. The current glucose threshold for GDM in Australia is set at a cut-point for adverse risks including macrosomia and neonatal hyperinsulinaemia. Definitions and guideline panels often fail to ask the affected public about their values and preferences. Community voices impacted by health policies should be embedded in the decision-making process.

Item ID: 62489
Item Type: Article (Research - C1)
ISSN: 1369-7625
Keywords: gestational diabetes, diagnosis, testing
Copyright Information: © 2020 The Authors. This article is Open Access under a Creative Commons (CC BY 4.0) Attribution license.
Funders: Bond University, National Health and Medical Research Council (NHMRC), NHMRC Centre for Research Excellence (NHMRC CRE), NHMRC Partnership Centre for Health System Sustainability (NHMRC CHSS), NHMRC Research Fellowship (NHMRC RF)
Projects and Grants: NHMRC grant 1106452, NHMRC CRE grant 1044904, NHMRC CHSS 9100002, NHMRC RF 1080042
Date Deposited: 11 Mar 2020 07:31
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 60%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 40%
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