title: Gestational diabetes: a triage model of care for rural perinatal providers.
abstract: OBJECTIVE
  Our purpose was to develop a protocol for surveillance, diagnosis, and management of diet-controlled gestational diabetes for rural care providers.
  
  
  METHODS
  Protocols for medical, nutritional, educational, and psychosocial education and treatment were developed. Data were collected on maternal-fetal outcome, birth weight, and provider time specific for diabetes. A diabetes educator, registered dietitian, and social worker provided protocol training on-site to rural providers. A control group had multidisciplinary care according to California Diabetes and Pregnancy Program protocols.
  
  
  RESULTS
  No significant difference in outcome between 39 protocol patients and 48 controls was noted except in time spent for diabetes care. The pilot providers averaged 4.3 hours and control providers 5.6 hours.
  
  
  CONCLUSIONS
  With appropriate protocols, rural providers can successfully treat diet-controlled gestational diabetes without a multidisciplinary team. This could extend the outreach of California Diabetes and Pregnancy Programs and potentially reduce costs.
authors.affiliation: Center for Women's Health Care, Eureka, California, 95503, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Weiderman
authors.forename: L
authors.initials: L
authors.lastname: Marcuz
mesh_terms: D001724:Birth Weight; D016640:Diabetes, Gestational / Q000178:diet therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D010348:Patient Care Team; D010353:Patient Education as Topic; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012424:Rural Population
chemical_list: D007328:Insulin