ORCID Profile
0000-0002-7012-3511
Current Organisation
Liverpool Hospital
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Publisher: American Diabetes Association
Date: 05-12-2018
DOI: 10.2337/DC17-2227
Publisher: Wiley
Date: 10-08-2020
DOI: 10.1111/AJO.13224
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/AJO.12973
Abstract: Women with gestational diabetes mellitus (GDM) have an increased risk of adverse pregnancy outcomes. This study examined predictors for GDM recurrence at their next pregnancy in a multi-ethnic population. Clinical outcomes of women with GDM at the index as well as the subsequent pregnancies were also compared. A retrospective review of women with GDM (between 2008 and 2016) who had a subsequent pregnancy at a tertiary institution was conducted. The clinical characteristics of both pregnancies were documented. Among 3587 singleton pregnancies complicated by GDM, 501 fell pregnant again and 367 (73.1%) developed GDM in their subsequent pregnancies. Subsequent pregnancies had higher birthweight (3426 ± 563 vs 3290 ± 506 g, P < 0.001) but the rate of pre-ecl sia was lower (1.0% vs 4.2%, P = 0.003). Univariate analysis showed that older age, prior history of GDM, pre-pregnant body mass index (BMI), two-hour glucose level on glucose tolerance test (GTT), insulin requirement at the index pregnancy, and inter-pregnancy weight gain were associated with recurrent GDM. Using stepwise logistic regression analysis, pre-pregnant BMI, glucose levels on GTT at index pregnancy and inter-pregnancy weight gain were independent predictors for recurrent GDM. The odds ratios for recurrent GDM among those who gained more than 8 kg were 20.5 (5.0-84.5), compared with those who lost over 5 kg between the two pregnancies. GDM recurrence rate was independent of ethnic backgrounds. Women with GDM have high risk of GDM recurrence at their next pregnancy. Inter-pregnancy weight gain is a strong predictor of recurrent GDM, and strategies to help women lose weight post-partum may be invaluable.
Publisher: American Diabetes Association
Date: 12-03-2018
DOI: 10.2337/DCI17-0068
Publisher: Wiley
Date: 12-2021
DOI: 10.1111/IMJ.15441
Abstract: During the Coronavirus disease 2019 (COVID‐19) pandemic, many outpatient services at public hospitals, including diabetes services, had adopted telehealth appointments for their clinic patients. There was concern that patients' glycaemic control may worsen during the pandemic. To assess glycaemic control of patients with diabetes attending telehealth consultations in 2020, compared to face‐to‐face reviews prior to pandemic. We conducted a retrospective review of patients with diabetes managed by telehealth consultations over 5 months at two metropolitan hospitals in Sydney. Their attendance rate, glycaemic control and unplanned admissions to hospital were assessed, and these were compared with the same period 12 months prior when patients were reviewed via face‐to‐face appointments. Between April and September 2020, the attendance rate for telehealth consultation at the diabetes services at the two hospitals was 88.9% (884 out of 994), which was higher than in 2019 (85.2% 818 out of 959 P = 0.016) when patients attended via face‐to‐face appointments. Of the 629 patients reviewed via telehealth in 2020 and who had been with our service for over 12 months, glycaemic control was better in 2020 (HbA1c 7.8 ± 1.4% (62 ± 15 mmol/mol)) compared with 12 months earlier (8.2 ± 1.7% (66 ± 19 mmol/mol) P 0.001). There was no difference in the number of unplanned admissions for this cohort in 2020 ( n = 58 9.2%) compared with 2019 ( n = 75 11.9% P = 0.100). The present study showed that for patients with diabetes who received care via telehealth consultations during the COVID‐19 lockdown, their glycaemic control was slightly better, and unplanned admission rates were not higher compared with those in the pre‐COVID‐19 period. Telehealth consultation offers an important care delivery option in the management of patients with diabetes under these circumstances.
No related grants have been discovered for Vincent Wong.