Our Diabetes Clinical Study Group brings together specialists to improve outcomes for women with diabetes who are planning pregnancy. Most women with diabetes have normal pregnancies, but the condition is linked to an increased chance of developing serious complications.
Women with diabetes are at high risk of foetal loss and malformation. These can be significantly reduced with simple interventions including achieving optimal glycaemic control preconception, high dose folic acid, and avoiding harmful medication preconception.
For women who have diabetes who do not plan their pregnancy, the risk of a serious complication such as miscarriage, stillbirth or the baby having a serious heart problem is around 1 in 10. With pre-conception planning and care, the risk of serious complications falls to around 1 in 50, which is almost the same as for women without diabetes. Many women are unaware of these risks, or how to mitigate them despite a strong evidence base for successful interventions.
Since the project launched, significant engagement with primary and secondary care teams across the region has taken place. The team have identified areas for improvement, with targeted actions to address sub-optimal areas. The project team are working with their respective clinical leads to erase any postcode lottery that may exist around pre-pregnancy care for women with diabetes. Quarterly meetings have enabled collaboration across the region.
The team has also developed a wider educational plan to improve health professional education. This includes free access to e-learning via Cambridge’s Diabetes Education Programme (CDEP). To date 230 access codes have been used and 308 certificates generated.
- Widespread and measureable engagement with primary care regarding the issues around pregnancy and diabetes had led to the identification of over 4000 women. To date, over 270 practices have responded to the request for running the database search and identifying women in the target group and 3608 information leaflets have been sent to women identified.
- The response from primary care has been impressive with some areas receiving replies from over 90% of practices (regarding the identification of women and leaflet mailing) within their area.
- The resources produced by the project team include the development of a new template for use by healthcare professionals across the EAHSN area, to enhance existing primary care IT packages to facilitate NICE standards for contraceptive and pre-pregnancy care for women with diabetes.
“We want pregnancy to be a safe and enjoyable experience for women with diabetes. The best way to achieve that goal is for women to start talking to their GP or specialist team involved in their care before they try to conceive, so that they can take simple steps which will make pregnancy safer for them and their baby. The EAHSN diabetes and pregnancy programme is a big step towards that goal in the East of England ”