Initial group dietary education compared to individual education in gestational diabetes mellitus management: Do outcomes differ?

Aims: To assess the effectiveness of Initial Group versus Initial Individual GDM dietary education in terms of insulin requirements and pregnancy outcomes. Methods: A retrospective audit of clinical data was conducted where English speaking women who received initial education in a group setting (01-2-2012 to 01-2-2014) (Group), were compared to women who received initial individual education with a dietitian (1-2-2010 to 31-1-2012) (Individual), all followed by one individual dietitian appointment. The same dietary information was provided in both settings. Data collected included attendance rates, insulin requirements, maternal weight gain, and rates of adverse birth outcomes. Data were compared by t-test or Chi-squared test Multivariate logistic regression analysis was conducted to determine independent predictors of insulin therapy. Results: Of 743 women, (362 Group and 381 Individual), Group women had a lower HbA1c at GDM diagnosis 5.3 +/- 0.6% versus 5.5 +/- 0.5% (34 +/- 66 mmol/mol versus 37 +/- 5.5 mmol/mol p < 0.0001). There were no other differences in baseline characteristics. More Group women required insulin (42.0% versus 34.6%, p = 0 048). Group education was found to be an independent predictor of insulin therapy (OR = 1.9 [1.29, 2.75] p < 0.001). Conclusions: Despite adjusting for all known potential confounders, unlike Individual education, Group education remained a significant predictor of insulin therapy (but resulted in similar therapeutic and pregnancy outcomes to Individual education). (C) 2018 Elsevier B.V. All rights reserved.