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j.jcjd.2017.08.052

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Abstracts / Can J Diabetes 41 (2017) S2?S16
patient satisfaction scores at the clinic have also increased(4.68/5
in 2016 vs 4.3/5 in 2013, p=0.01).
Conclusions: Metformin is comparable to insulin in glycemic control
and pregnancy outcomes for management of GDM. Introduction of
this protocol has resulted in improved patient satisfaction and clinic
e?ciency.
44
?
Conjoint Associations of Gestational Diabetes and
Hypertension with Diabetes, Hypertension, and Cardiovascular
Disease in Parents: A Retrospective Cohort Study
ROMINA PACE*, ANNE SOPHIE BRAZEAU, SARA MELTZER,
ELHAM RAHME, KABERI DASGUPTA
Montreal, QC
Background: The conjoint association of gestational diabetes (GDM)
and gestational hypertension (GH) with cardiometabolic disease has
not been well studied.
Objective: To evaluate combined GDM/GH risk indicator in both
mothers and in fathers given shared spousal behaviours and
environments.
Methods: In this population-based retrospective cohort study, GH
was identi?ed in matched pairs (GDM vs. no GDM, matched on age
group, health region, year of delivery) of mothers with singleton
live births (Quebec, Canada; 1990?2007). 64,232 couples were categorized based on GDM/GH status (?neither?; ?either?; or ?both?).
Associations with diabetes, hypertension, and cardiovascular disease
(CVD) and mortality composite were evaluated (12 weeks postpartum to March 2012; Cox proportional hazard models).
Results: Compared to the ?neither? category, having ?either? GDM
or GH was associated with incident diabetes (HR:14.7, 95% CI: 12.9,
16.6), hypertension (HR:1.9, 95% CI:1.8, 2.0), and CVD and mortality (HR:1.9, 95%CI:1.5, 2.4). Having ?both? demonstrated associations of greater magnitude (diabetes: HR:36.9, 95%CI:26.0,52.3;
hypertension HR:5.7, 95%CI:4.9,6.7; CVD HR: 3.5, 95%CI:2.0, 6.0).
Associations with diabetes were also observed in fathers (either
HR:1.2,9 5%CI 1.1, 1.3; both HR1.8, 95%CI:1.4, 2.3;).
Conclusions: A combined GDM/GH indicator demonstrates associations with cardiometabolic disease in mothers and diabetes in
fathers, with stronger associations when both GDM and GH occur.
45
Early Diabetes Screening, Before Hospital Discharge, in
Postpartum Women with Gestational Diabetes: A New
Validated Method
JEAN-LUC ARDILOUZE, GARRY X. SHEN, LORRAINE LIPSCOMBE,
ILANA HALPERIN, ELIZABETH SALAMON, SORA LUDWIG,
VINCENT WOO, JULIE MENARD, ANNIE OUELLET,
MARIE-HELENE PESANT, MARIE-FRANCE HIVERT,
JEAN-PATRICE BAILLARGEON
Sherbrooke, QC
Rationale: Diabetes screening with an oral glucose tolerance test
(OGTT) is recommended 6?24 weeks after gestational diabetes (GD).
However, screening rates are low. We hypothesized that an OGTT,
performed before hospital discharge, can identify women with higher
risk of glucose intolerance.
Objectives: 1) To determine and validate the optimal 2-hour plasma
glucose (2-hPG) threshold value before hospital discharge (OGTT-1)
that rules out glucose intolerance at 6?24 weeks (OGTT-2); 2) to
assess women?s preferred time for testing.
Methods: Prospective multicenter cohort study of women with GD
who performed both OGTTs and were randomly allocated to the
determination (n=110) or validation (n=220) cohort. A satisfaction questionnaire was completed after each OGTT. ROC curves were
used to determine OGTT-1 2-hPG thresholds, using OGTT-2 as the
reference standard.
S15
Results: Determination and validation cohorts had similar age
(32.2�4/31.5�1 years), BMI (28.9�0/29.0�4 kg/m2), ethnicity (78.2/78.2% Caucasian), OGTT values and timing. In the determination cohort, the optimal 2-hPG cut-off value was 8.0 mmol/L.
In the validation cohort, only 3.6% of the 53% who were below this
cut-off had glucose intolerance on OGTT-2. Sensitivity was 84.0%,
speci?city 57.9%, positive predictive value (PV) 20.4%, negative PV
96.6%. Most women (81%) preferred the early test.
Conclusion: An OGTT before hospital discharge accurately rules out
glucose intolerance in half of postpartum GD patients, eliminating
the need for later testing. A 2-hPG threshold of 8.0 mmol/L identi?es higher-risk women who may bene?t from targeted interventions.
46
Moms in Motion-Social Media-Assisted Prenatal Education
Program Increases Participation of Pregnant Women in
Prenatal Education in Manitoba First Nations Communities
AMY HUI, BRANDY WICKLOW, ELIZABETH SELLERS, JON MCGAVOCK,
NATHAN NICKEL, SORA LUDWIG, MARGARET MORRIS, LARRY WOOD,
WANDA PHILIPS-BECK, RHONDA CAMPBELL, FRANCES DESJARLAIS,
GLORIA MUNROE, MAXINE ROULETTE, DOLORIS BEAULIEU,
CONNIE KUZDAK
Winnipeg, MB
Previous studies have demonstrated that First Nations (FN) pregnant women urgently need feasible and culturally appropriate prenatal education. However, the prenatal class attendance rate is low
in many FN communities, or the program is not active in some communities. Socioeconomic and geographic barriers have been identi?ed as major underlying mechanism for the low access to prenatal
education in rural-living FN pregnant women in Manitoba. Access
to the internet and Facebook is widespread. We developed a
Facebook-linked website, www.momsinmotion.ca, to deliver prenatal and breastfeeding in the communities. The content includes
video/audio education on healthy eating, physical activity, diabetes/
obesity prevention and breastfeeding promotion. The website was
advertised through community radio/TV station and workshops in
3 FN communities. Pregnant women in the communities can sign
up through internet to access the information 81/220 of pregnant
women signed up for the e-education from the 3 FN communities
from July, 2015 to December, 2016, which represented 37% of total
pregnancies in the 3 FN communities. The prenatal education delivery rate was increased by 3 times (p<0.001) compared to that in
2011-13 in those communities (12%). Preterm birth and microsomia and macrosomia were reduced in the communities by 32%, 37%
and 5% after the launch of e-education compared to that before, but
the differences were not statistically different. In conclusion,
e-education increases the participation of prenatal education of ruralliving FN pregnant women and potentially improves neonatal outcomes in the communities.
Supported by the Lawson Foundation.
47
Perception of Stigma is Associated with Poor Diabetes Control
Among Adolescents and Young Adults with Type 1 Diabetes
ANNE-SOPHIE BRAZEAU, MICHAEL WRIGHT, MERANDA NAKHLA,
MELANIE HENDERSON, CONSTADINA PANAGIOTOPOULOS,
DANIELE PACAUD, ELHAM RAHME, DEBORAH DA COSTA,
KABERI DASGUPTA
Montreal, QC
Aim: Stigma related to chronic disease is rejection, judgement, or
exclusion related to the chronic disease itself. We aim to determine the prevalence of stigma among youth and young adults with
type 1 diabetes (T1D) in Canada and its association with diabetes
control.
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