A cost‑efficient dietitian diabetes educator model of care for gestational diabetes mellitus: A prospective service evaluation in a tertiary maternity hospital — ASN Events
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A cost‑efficient dietitian diabetes educator model of care for gestational diabetes mellitus: A prospective service evaluation in a tertiary maternity hospital (#118)

Melissa KY Lee 1 2 , Sharon Chancellor 1 , Josephine Laurie 1 3 , Shelley Wilkinson 1 4 , Rumbi Mutsekwa 5 , Linda Orazio 1
  1. Obstetric Medicine, Mater Mothers' Hospital, South Brisbane, QLD, Australia
  2. Logan Endocrine and Diabetes Services, Logan Hospital, Meadowbrook, QLD, Australia
  3. Doctor of Medical Leadership, University of Queensland, South Brisbane, QLD, Australia
  4. School of Pharmacy, University of Queensland, South Brisbane, QLD, Australia
  5. Nutrition and Dietetics, Mater Health, South Brisbane, QLD, Australia

Background & Aim

 

Gestational diabetes mellitus (GDM) affects up to one in five pregnancies in Australia and contributes substantially to increasing workload and cost pressures in maternity diabetes services. Traditional GDM care commonly involves separate consultations with a credentialled diabetes educator (CDE) and an accredited practising dietitian (APD), resulting in duplicated education, fragmented care, and increased staffing costs. With a growing workforce of dietitians dual‑credentialled in diabetes education, a Dietitian Diabetes Educator (DDE) model offers an opportunity to improve efficiency without compromising care quality. This study aimed to evaluate the clinical outcomes and cost impact of a DDE model compared with the traditional dual‑clinician approach.

Methods

 

A prospective service evaluation was conducted at Mater Mothers’ Hospital, South Brisbane. Women diagnosed with GDM were managed under a DDE‑led clinic during a 12‑week pilot period. The DDE delivered integrated diabetes education, medical nutrition therapy, blood glucose monitoring support, and escalation pathways. Outcomes assessed included timeliness of care, early glycaemic control at Day 7 and Day 14, pharmacotherapy initiation, maternal and neonatal outcomes, patient satisfaction, and staffing cost analysis.

Results

 

Twenty‑five women were managed under the DDE model. Most were reviewed within 7 days of diagnosis with high completion of Day 14 follow‑up. Mean fasting and post‑prandial blood glucose readings improved between Day 7 and Day 14, and fasting readings within target by Day 14. Rates of insulin and metformin initiation were consistent with expected GDM populations, with no adverse maternal or neonatal safety signals observed. Patient satisfaction was high. Cost analysis demonstrated a 34% reduction in staffing costs and an improved service margin compared with the traditional dual‑clinician model. Outcome data forthcoming as participants continue to deliver.

Discussion/Conclusion

 

The DDE model delivers clinically safe and effective GDM care while substantially reducing service delivery costs, supporting a scalable, value‑based workforce solution for maternity services.