Impact of the updated 2025 Australasian Diabetes in Pregnancy Society recommendations for the screening, diagnosis and classification of gestational diabetes mellitus on clinic referral rates: a 6-month audit at Gold Coast University Hospital — ASN Events
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Impact of the updated 2025 Australasian Diabetes in Pregnancy Society recommendations for the screening, diagnosis and classification of gestational diabetes mellitus on clinic referral rates: a 6-month audit at Gold Coast University Hospital (#143)

Evangelia Haralabopoulos 1 , Nadine Coker 1 , Annabelle Lamprecht 1 2
  1. Department of Obstetric Medicine/Endocrinology, Gold Coast University Hospital, Queensland Health, Southport, Queensland, Australia
  2. School of Medicine, Griffith University, Gold Coast Campus, Queensland, Australia

Background:
Gestational diabetes mellitus (GDM) and other forms of hyperglycaemia in pregnancy are becoming increasingly common. The 2025 updated guidelines from the Australasian Diabetes in Pregnancy Society (ADIPS) introduce revised diagnostic thresholds, including gestational diabetes diagnosis based on a 75 g oral glucose tolerance test (OGTT) with fasting plasma glucose 5.3–6.9 mmol/L, 1-hour glucose ≥ 10.6 mmol/L, or 2-hour glucose 9.0–11.0 mmol/L. The guidelines also recommend early risk-based screening using first-trimester HbA1c in patients with risk factors. These changes aim to improve diagnostic accuracy and reduce adverse maternal and neonatal outcomes. However, their impact on clinical service demand remains unclear, particularly in a rapidly expanding health service such as the Gold Coast University Hospital, one of Australia’s fastest growing health services.

Aim:
To evaluate the effect of the 2025 updated ADIPS guidelines on GDM referral rates and associated workload within a tertiary antenatal diabetes service over a 6-month period.

Methods:
A retrospective clinical audit was conducted at Gold Coast University Hospital. Data was collected for all pregnant women undergoing screening for gestational diabetes over a 6-month period following implementation of the updated guidelines. Outcomes included rates of GDM and overt diabetes in pregnancy (DIP) diagnoses, referral patterns, and total clinic caseload. These were compared to historical data based on previous diagnostic criteria to assess relative change and model future service requirements.

Results:
Implementation of the updated ADIPS diagnostic criteria resulted in changes to diagnostic classification, consistent with higher glucose thresholds and structured early screening pathways. GDM referrals decreased from 340 in the pre-updated guideline period (February–July 2025) to 186 in the post- updated guideline period (August 2025–January 2026), representing a 45.3% reduction in referrals.

Conclusion:
The 2025 ADIPS guideline changes were associated with a substantial reduction in referral rates in a tertiary centre. This highlights targeted identification of GDM to inform its ongoing management and its impact on pregnancy and neonatal outcomes.