Subsidized Screening and Lifestyle Management of Gestational Diabetes Mellitus in Rural China: A Multi-Centre, Randomized Controlled Trial
Author(s)
Xu T1, Xia Q2, Fang H3
1capital medical univerisity, beijing, China, 2Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia, 3peking univerisity, beijing, China
Background The burden of gestational diabetes mellitus (GDM) is escalating, and the control rate is poor in rural China. This study assessed the effectiveness of a GDM subsidy program on promoting GDM screening and management in rural China. Methods This study was a multicenter, randomized controlled trial launched at antenatal clinics of 6 rural hospitals from 3 provinces in China. Pregnant women were recruited in the 24-28th week of gestation between 1st September 2018 and 30th September 2019. We randomly assigned participants to either the intervention group [with subsidized care] or the control group [with usual care]. The primary outcomes were maternal and neonatal complications. We reported binary measurements as risk ratios with 95% confidence intervals (CIs), and continuous measurements as mean differences with 95% CIs. Findings A total of 3294 pregnant women were recruited(intervention group:1649; control group:1645), and followed up by delivery for more than 95% of participants. The rates of GDM screening were high in both the intervention (97.2 % [1602/1649]) and control groups (94.5% [1555/1645]). Pregnant women in the intervention group had lower energy intake and more physical activity times than those in the control group (P values <0.05). The percentage of doctor visits with glucose retests for the GDM patients in the intervention group was significantly higher than that in the control group (1.5 vs. 0.4 visits; P<0.01). The percentage of pregnant women in the intervention group suffering from composite maternal and neonatal complications was lower than that in the control group (38.6% vs. 42.0%, P=0.05), and the difference was more evident in GDM subset (38.8% vs. 48.6%, P=0.03). Interpretation In rural China, a subsidized GDM screening and lifestyle management program by incentivizing both pregnant women and medical staff led to improved maternal and neonatal outcomes versus usual care.
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Code
CO29
Topic
Clinical Outcomes, Health Policy & Regulatory, Study Approaches
Topic Subcategory
Clinical Trials, Comparative Effectiveness or Efficacy, Public Spending & National Health Expenditures
Disease
Diabetes/Endocrine/Metabolic Disorders