Gestational Diabetes Mellitus in Pregnancy Clinical Trial
Official title:
Améliorer la Detection et la Prise en Charge du diabète Gestationnel au Niveau Des établissements de Soins de santé Primaires au Maroc
A situational analysis on gestational diabetes conducted in 2015 in two districts in Morocco
revealed difficulties in accessing screening for gestational diabetes (GDM) and delays in
receiving appropriate care. Based on the results of the situational analysis, the
investigators developed this proposal in close collaboration with the Moroccan research group
on gestational diabetes composed of representatives of the Ministry of Health, researchers,
members of professional organizations and specialists in the domains of endocrinology,
gynecology, neonatal health and nutrition. The investigators opted for an hybrid
implementation effectiveness trial to evaluate both clinical effectiveness of the proposed
screening and initial management strategy and its implementation at the first level of care.
The objectives of this study are thus to evaluate the feasibility of a decentralized strategy
of screening for GDM and the initialization of GDM treatment already through the primary
level of care and to assess its potential for scaling-up. Specific objectives of this study
are to augment universal access to screening and management of gestational diabetes and to
increase the competencies of health care providers at first level health care facilities to
detect, start initial treatment and to improve follow-up of affected women. By comparing
active screening and treatment initiation through first line health facilities with the
existing practices, the investigators would like to explore the effect of the new model on
maternal and newborn outcomes such as weight gain in pregnancy, occurrence of delivery
complications and birth weight. The investigators will further assess the acceptability of
screening and initial management of GDM through first line health services by health care
providers and by pregnant women diagnosed with GDM and the impact of two different screening
approaches on the lifestyle of affected mothers.
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