Quality statement 5: Review after a diagnosis of gestational diabetes

Quality statement

Women diagnosed with gestational diabetes are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

Rationale

Women diagnosed with gestational diabetes should have specialist advice and treatment in a timely manner, and should be reviewed by members of the joint diabetes and antenatal care team within 1 week of being diagnosed. The joint team should provide the woman with advice, including why gestational diabetes occurs, potential risks and complications, and treatments aimed at reducing those risks.

Quality measures

Structure

a) Evidence of local arrangements to provide a joint diabetes and antenatal care team.

Data source: Local data collection.

b) Evidence of local arrangements and written clinical protocols to ensure that women diagnosed with gestational diabetes are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

Data source: Local data collection.

Process

Proportion of women diagnosed with gestational diabetes who are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

Numerator – the number in the denominator who are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

Denominator – the number of women diagnosed with gestational diabetes.

Data source: Local data collection.

Outcome

a) Maternal satisfaction.

Data source: Local data collection.

b) Perinatal morbidity.

Data source: Local data collection.

c) Perinatal mortality.

Data source: Local data collection.

d) Maternal adverse outcomes.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (in secondary and community care) ensure that referral pathways are in place so that women diagnosed with gestational diabetes are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

Healthcare professionals (in joint diabetes and antenatal care teams) ensure that they see women diagnosed with gestational diabetes within 1 week of diagnosis.

Commissioners (NHS England area teams and clinical commissioning groups) ensure that they commission services in which women diagnosed with gestational diabetes are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis.

What the quality statement means for patients

Pregnant women who are diagnosed with gestational diabetes (that is, diabetes that develops during pregnancy) have an appointment with a joint diabetes and antenatal care team within 1 week of their diagnosis.

Source guidance

Definitions of terms used in this quality statement

Joint diabetes and antenatal care team

A clinic with a multidisciplinary team consisting of an obstetrician, a diabetes physician, a diabetes specialist nurse, a midwife and a dietitian.

[National service framework for diabetes]

Diagnosis of gestational diabetes

Diagnose gestational diabetes (using a 75 g 2‑hour oral glucose tolerance test) if the woman has either:

  • a fasting plasma glucose level of 5.6 mmol/litre or above or

  • a 2‑hour plasma glucose level of 7.8 mmol/litre or above.

[Adapted from Diabetes in pregnancy (NICE guideline NG3) recommendations 1.2.6 and 1.2.8]