Cathrine Scavenius, MD, PhD completed her PhD scholarship on “Screening for Gestational Diabetes: Is Implementation of New Criteria Justified in a Danish Population?” at Department of Gynaecology and Obstetrics, Copenhagen University Hospital – Nordsjællands Hospital Hillerød and Department of Clinical Medicine, Faculty of Health Sciences and Medicines, University of Copenhagen with a grant from Danish Diabetes Academy (DDA) (now known as Danish Diabetes and Endocrine Academy).

We have asked Cathrine Scavenius to reflect on her time as a DDA-funded researcher.

What are the most important findings of your research project?

The most important finding from a national perspective, is a 10-fold increase in gestational diabetes mellitus (GDM) prevalence if changing the current Danish diagnostic criteria to the ones recommended by the WHO. Further, we observed that women currently left untreated by Danish criteria have a significantly higher risk of adverse outcomes. These results raise the ethical dilemma of whether to medicalise a higher number of pregnancies while at the same time improving outcomes for more women and their children.

Personally, I find our observation of marked differences in screening procedures across obstetric departments in Denmark caused by insufficient guideline implementation very interesting. Such differences could lead to unequal treatment offers – but although challenging, optimising guideline implementation is a tangible solution.

Also, our finding that even small bias in blood glucose measurements can lead to large differences in the resulting GDM prevalence across Danish laboratories, highlights the importance of recognising and acknowledging the procedural limitations when setting diagnostic criteria.

How is your research project relevant to the public?

Our work evaluates different aspects of the current practice and procedures of GDM screening in Denmark. These data have contributed to the recent guideline work on GDM screening and treatment by the Danish Society of Obstetrics and Gynecology. The new proposed guideline has been debated and endorsed across interdisciplinary medical societies, including endocrinologists, general practitioners and midwives, and the final proposal is currently under review at the National Board of Health. The suggested revisions from the current to the new guideline are supported by recent evidence-based research and approach the international recommendations, and thus include essential modifications since the latest revision from 2014.

What was a highlight in your time as a DDA-funded researcher?

A great highlight as a DDA grant recipient has been to attend all the wonderful meetings and educational workshops hosted by the DDA/DDEA. It has felt like ‘coming home’ every time being surrounded by such warm, dedicated people and I have felt extremely lucky to be a part of this community.

Which challenges have you encountered (and overcome) on your way?

The primary struggle throughout the PhD process has been to ensure funding as the data collection demanded quite a workload and included interdisciplinary manpower and collaborations. Further, the COVID pandemic forced a certain extra and unexpected flexibility to the PhD plan – but this taught us such a great lesson; that sometimes the greatest gifts come in small packages.

If you could go back in time and give yourself one piece of advice before starting your research project, what would it be?

I have always felt most comfortable being in control and having a safety net, why I have seldomly taken chances. But sometimes it is good not to pick the safe solution, and finding the courage to do so can often be guided by senior supervisors. Therefore, my advice to my “new-student” self would be: Don’t be afraid to aim high! But remember, it takes a team to get there.

What has your DDA grant meant for your research, education, and network?

The grant secured my PhD salary, for which I am extremely grateful. Further, the DDA has given me the opportunity to establish and nurture a collegial and social network that I have not found similar anywhere else. In addition, the many great workshops and symposiums held by the DDA are a great supplement to the mandatory PhD courses.

What is next for you?

I have returned to clinical work and started the journey to become a specialist in obstetrics.

Cathrine Scavenius’ closest collaborators have been Tine Dalsgaard Clausen, Senior Consultant, PhD, Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital – Rigshospitalet; Dorte Møller Jensen, Professor, PhD, Steno Diabetes Center Odense, Department of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark; Peter Damm, Professor, DMSc Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital – Rigshospitalet, Department of Clinical Medicine, Faculty of Health Sciences and Medicines, University of Copenhagen; Martin Overgaard, Associate Professor, MSc, PhD, Department of Clinical Biochemistry, Odense University Hospital, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark; and H. David McIntyre, Professor, Head of Mater Clinical Unit, MD, FRACP, Mater Research Faculty of Medicine, The University of Queensland, Australia.

Cathrine Scavenius have recieved co-funding for her PhD project from Copenhagen University Hospital Nordsjællands Hospital Hillerød; Jaschafonden; the Capital Region’s Research Foundation for Health Research; Steno Diabetes Center Odense; Tvergaard Fonden; Frimodt-Heineke Fonden; The Medical Association’s Research Fund; The Danish Diabetes Association; The 2021 Department of Clinical Medicine Research Fund, University of Copenhagen; and the Region of Southern Denmark and Region of Zealand Common Fund.

We wish Cathrine Scavenius all the best in her future career.