One of our BUSPH Alum, Ms. Leonor Guariguata, has alerted us about an IDF opportunity for an IH/Epi student practicum hopefully to be conducted as soon as possible.

DETAILS:  The International Diabetes Federation wishes to be able to provide global estimates of the prevalence of gestational diabetes. An initial attempt at summarising the literature found that there were too many differences in methodology to be able to draw sensible conclusions about the prevalence (or incidence) of GDM in different parts of the world.

The issues are:

i) different definitions of GDM (i.e. different loads of glucose given at different time and different cut-offs). This is being addressed by a WHO consensus meeting and we anticipate that a report will be published later this year.

ii) most studies are clinic/hospital-based and do not allow for biases in the population represented by the hospital, e.g. age, ethnicity, socio-economic group. This may be more of a problem in low- and middle-income countries, where older women may be more likely to give birth at home, wealthier women may be more likely to give birth in large private health facilities, etc.

iii) GDM is defined as diabetes first detected during pregnancy. This means that previously undiagnosed diabetes will, by definition, be classified as GDM. In settings where the proportion of people with undiagnosed diabetes is high (e.g. 80-90% in many African countries) this could lead to high estimates of GDM that are in fact driven mostly by the under-lying prevalence of diabetes. Attributing the cause of diabetes to GDM or just DM could lead to very different interventions and policies.

The IDF model approach to GDM prevalence estimates is a stepped approach to gathering the data required to calculate adjusted estimates GDM prevalence. A simple spreadsheet tool takes input for each of the factors and calculates estimates that are adjusted for socio-economic status, ethnic mix, age and underlying prevalence of diabetes. The approached is “stepped” in that it is possible to use estimates for each of the factor, but also provides guidance on conducting surveys to determine up-to-date local estimates if resources are available.

IDF would like the practicum student to do the following:

i) review the calculations set up in a spreadsheet;

ii) complete the final set of calculations in the spreadsheet (more details will be provided to the student)

iii) use the spreadsheet (i.e. IDF model approach) to adjust some published estimates of GDM prevalence. It will probably be necessary to search for data to fill in the spreadsheet (e.g. age=-specific fertility rates) and also to make some best-guess estimates for other elements.

iv) write a report on findings, with an option to co-author a publication depending on time

The student will work from home and have regular conference calls with the epidemiology team at the IDF global office in Brussels.

Interested students can send CV & cover letter to :

Leonor Guariguata | Biostatistician

tel +3226795547 | Leonor.Guariguata@idf.org

International Diabetes Federation

166 Chaussée de La Hulpe, B-1170 Brussels, Belgium

tel +32-2-5385511 | fax +32-2-5385114

info@idf.org | www.idf.org | VAT BE 0433.674.528