Introduction: Approximately 700 000 women give birth in England and Wales each year with up to 5% of these women having either pre-existing diabetes or gestational diabetes (GDM). Women who have diabetes during pregnancy, it is estimated that approximately 87% have GDM. It is well recognised that early diagnosis of diabetes aids in timely intervention to reduce long-term complications.
Objectives: To assess the screening for diabetes mellitus in post-delivery women diagnosed with GDM as per NICE guidelines 2015 part 1.6.
Methodology: The diagnosis of GDM was made with results of oral glucose tolerance test: fasting blood glucose (FBS) ≥6.1 mmol/l and 2 h blood sugar ≥7.8 mmol/l. 91 patients were identified with GDM between 1st January 2014 and 2nd January 2015 based on records provided by the biochemistry laboratory and diabetes centre. We checked results of these patients for FBS performed between 6 and 13 weeks post-delivery (audit standard 1). For those who did not have the test done, we checked their results for HbA1c/FBS between 13 and 20 weeks post pregnancy (audit standard 2). Exclusion: pre-existing diabetes.
Results: 27% undertook a FBS test between 6 and 13 weeks. 7 and 17% of remaining 66 patients undertook FBS and HbA1c respectively 1320 weeks post-delivery.
Conclusion: 27% adhered to NICE standard 1. 16.5% adhered to NICE standard 2. 56.5% had no screening. None of the patients had OGTT after delivery showing 100% compliance.
Recommendations: Diabetes team will hand deliver blood test request forms to patients in the clinic and encourage them to be tested 613 weeks post-delivery. Enhance awareness in primary care by arranging audit presentations by diabetes specialist nurses at GP practices. Reminder alerts can be placed on electronic patient records with GP consensus. We aim to re-audit in 18 months to re-evaluate the effectiveness of implemented methods.