Diabetes in Pregnancy
Partnership

Improving systems of care and services for women with diabetes in pregnancy (DIP) and their babies in rural and remote (NT & FNQ) Australia

The Northern Territory and Far North Queensland Diabetes in Pregnancy Partnership

The DIP Partnership commenced initially in the Northern Territory (NT) in 2011. The partnership is between researchers, policy makers and health service providers. It aims to improve systems of care and services for women with diabetes in pregnancy in remote northern Australia and to improve the care and outcomes for women with diabetes in pregnancy and their babies.

Further funding in 2015 enabled the NT DIP Partnership to expand, thus developing an alliance with Far North Queensland (NT & FNQ Diabetes in Pregnancy Partnership) and collaborating with Canadian researchers.

Diabetes in pregnancy (DIP) is associated with an increase in short-term and long-term health risks for mothers and their babies. It also provides a unique opportunity to improve the future health outcomes of women and their babies.

Partnership Benefits

The benefits of the partnership are wide-reaching for the broader community and the health of future generations.

A better understanding of antenatal and birth outcomes, as well as of challenges concerning antenatal and post-partum care in the setting of diabetes in pregnancy may contribute to informing design of policy, practice and future interventions. In particular, this partnership will continue to inform clinical guidelines regarding best practice care of mothers with diabetes in pregnancy and in the post-partum period.

Benefits to the individual may include improved care of women with diabetes in pregnancy and therefore improved outcomes for women and their babies. The outcomes of improving models of care for women with diabetes in pregnancy include both short and longer term benefits for the pregnancy and for the health of the mother and the baby.

Ethics

All components of the partnership have current approval from the relevant Human Research Ethics Committee.

Principal Chief Investigator

Associate Professor Louise Maple-Brown

Louise.Maple-Brown@menzies.edu.au

Stay up to date

For program updates, newsletters and upcoming events in each area, please visit the Menzies website.

Northern Territory (NT)

Pregnancies complicated by diabetes carry significant risks, but also provide an opportunity for early intervention in the life course of both mother and baby.

We have developed a partnership between researchers, health care providers, and policy organisations in the NT and have extended the partnership to Far North Queensland to address this issue.

The aim of the partnership is to improve systems of care and services for women with diabetes in pregnancy (DIP) and their babies in rural and remote (NT & FNQ) Australia.

Components of the NT Partnership

  1. The establishment and development of the NT Diabetes in Pregnancy Clinical Register.
  2. Models of Care: Enhancement of models of care to improve health service delivery for women with DIP. Earlier work focused on the antenatal management of women with DIP before moving to the inter-pregnancy interval to encompass pre-conception management and post-partum follow-up.
  3. Research: PANDORA (Pregnancy and Neonatal Diabetes Outcomes in Remote Australia) is a longitudinal birth cohort study that will assess short-term and long-term pregnancy outcomes.

The Northern Territory DIP Clinical Register

The aim for the NT DIP clinical register is to improve the management and follow-up of women with DIP, assist with quality assurance and act as an epidemiological tool, to establish DIP burden and its variability over time, place and ethnicity.

All women with diabetes in pregnancy, residing in the NT, are eligible for inclusion in the register. Women aged 16 years and below must have verbal approval from a parent or guardian.

Referral

To refer to the NT DIP Clinical Register, please provide information for women regarding the clinical register and use the standard template (electronic versions are available from PCIS and Communicare).

Access

Health Professionals involved in the direct care and/or care coordination of clients with DIP may apply for access, in accordance with the NT Information Act and as outlined in the NT DIP Clinical Register Access Policy Statement.

Removal from the register

Women can request to have their information removed from the register at any time.

Data Custodianship and Use

The data remains the property of the relevant partner organisation/health care provider.

Biannual reports of aggregated (NT-wide) de-identified data are prepared by the NT & FNQ DIP Partnership Steering Committee for the purposes of quality assurance and are circulated to all relevant health care providers in their jurisdictions.

Clinical audits in the NT, using NT clinical register information may be undertaken following an application for consideration by the NT & FNQ DIP Steering Committee.

PANDORA

(Pregnancy and Neonatal Diabetes Outcomes in Remote Australia)

PANDORA is a longitudinal birth cohort study that will assess outcomes of diabetes in pregnancy (DIP) in the Northern Territory, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical practice guidelines of management of DIP and follow-up of mother and baby.

The study will also inform the design of further work to reduce risk of future obesity, diabetes and cardiovascular disease in both the mothers and babies.

Recruitment commenced in 2011 and was completed in February 2017. Over 1100 women and their babies, with and without diabetes in pregnancy, were recruited during pregnancy across all NT regions. Participants are women with any type of DIP (type 1 diabetes, type 2 diabetes, gestational diabetes mellitus) and women without DIP and their children. Approximately 50% of PANDORA women are Aboriginal women. Our cohort is unique for the high proportion of mothers with pre-existing type 2 diabetes.

Measurements include cord blood and detailed neonatal body fat assessments.

PANDORA Wave 1

This project involves clinical assessments of a subgroup of PANDORA mothers and their babies’ across all NT. Participants are Aboriginal and Europid mothers (their child from 18 months of age) with type 2 diabetes, gestational diabetes mellitus or without DIP and their child ( age 18-48 months).

PANDORA Wave1 aims to examine cardio-metabolic risk factors in these mothers and their infants in order to identify predictors of chronic disease such as obesity, diabetes and heart disease later in life. We will explore the maternal and infant consequences of diabetes in pregnancy to gain insights to inform the timing and types of interventions to prevent the development of later chronic conditions.

We perform detailed assessments of both the mother and her child including body measurements, blood pressure, blood tests ( including for epigenetics ). In addition, for the child we perform an aortic ultrasound, assessment of body fat, and a developmental assessment. We ask the mother a number of questions about her and her child including demographics, smoking and alcohol use, nutrition, physical and mental health and about her child’s development and well-being.

PANDORA Mothers

This is a pilot study to assess if enhanced support post-pregnancy for Aboriginal and Torres Strait Islander women with diabetes in pregnancy results in improved uptake of recommended health checks post-partum. This includes identifying the enablers and barriers to the uptake of recommended post-pregnancy health checks.

PANDORA Contact

Email: pandora@menzies.edu.au
Phone: 08 89468695

Contact

For further information regarding the NT DIP Clinical Register, please email DIPClinicalRegister.THS@nt.gov.au

Funding

Thank you to National Health and Medical Research Council, the Global Alliance of Chronic Diseases, Diabetes Australia Research Program, Channel 7 Children Research Foundation, Donation from Ian Albrey and Edwina Menzies.

Our Northern Territory project partners

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Far North Queensland

Pregnancies complicated by diabetes carry significant risks, but also provide an opportunity for early intervention in the life course of both mother and baby.

We have developed a partnership between researchers, health care providers, and policy organisations in the NT and have extended the partnership to Far North Queensland to address this issue.

The aim of the partnership is to improve systems of care and services for women with diabetes in pregnancy (DIP) and their babies in rural and remote (NT & FNQ) Australia.

Components of the FNQ Partnership

  1. Introduction of the FNQ DIP Clinical Register to improve systems of care
  2. Enhanced models of diabetes in pregnancy care suitable to the FNQ regions and the augmentation of health care professionals’ capacity for managing diabetes in pregnancy across all health organisations.

The FNQ DIP Clinical Register

    All FNQ women with diabetes in pregnancy will be invited to be included in the clinical register by their health care professional.

    A referral with routine antenatal information can be emailed or faxed through the project register staff. Web-based access to the clinical register is available for health professionals assisting in the care of pregnant women with diabetes.

    Information from the register will be used to assist with planning and improving models of healthcare and service delivery for women with diabetes in pregnancy. The register will also be used to identify women who require postpartum follow up after pregnancy.

Contact

FNQ DIP Partnership Coordinator
DIPPINQ@menzies.edu.au
Phone: 07 4226 4639

Funding

Thank you to National Health and Medical Research Council and the Global Alliance of Chronic Diseases.

Our Far North Queensland project partners

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