Quality statement 7: Annual HbA1c testing after gestational diabetes

Quality statement

Women who have had gestational diabetes have an annual HbA1c test.

Rationale

Women who have had gestational diabetes are at increased risk of getting it again in future pregnancies. They are also at higher risk of type 2 diabetes: if they are not diagnosed with type 2 diabetes in the immediate postnatal period, they are still at high risk of developing it in the future. Early detection of type 2 diabetes by annual HbA1c testing in primary care can delay disease progression and reduce the risk of complications. Annual testing can also reduce the risk of uncontrolled or undetected diabetes in future pregnancies.

Quality measures

Structure

Evidence of local arrangements and written clinical protocols to ensure that women who have had gestational diabetes have an annual HbA1c test.

Data source: Local data collection.

Process

Proportion of women who have had gestational diabetes who have an annual HbA1c test.

Numerator – the number in the denominator who have had an HbA1c test in the last 12 months.

Denominator – the number of women who have had gestational diabetes and whose baby was born at least 12 months ago.

Data source: GP Patient Survey and local data collection.

Outcome

Earlier detection of type 2 diabetes.

Data source: Local data collection.

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

Service providers (in primary care) ensure that systems are in place so that women who have had gestational diabetes have an annual HbA1c test.

Healthcare professionals (in primary care) ensure that they test HbA1c levels annually for women who have had gestational diabetes.

Commissioners (NHS England area teams and clinical commissioning groups) ensure that they commission services that provide annual HbA1c testing for women who have had gestational diabetes.

What the quality statement means for patients

Women who have had gestational diabetes have the HbA1c levels in their blood measured once a year. This is to check whether they have type 2 diabetes, or are at risk of getting it.

Source guidance