A service improvement project to improve follow up screening rates of women with gestational diabetes

Gestational diabetes mellitus (GDM) is defined as hyperglycemia first recognised during pregnancy (World Health Organisation [WHO], 2013). In 2017, it was approximated that 21.3million live births were impacted by various forms of hyperglycaemia. Of these, roughly 18.4 million were attributed to GDM, constituting 86.4% of all instances of hyperglycemia in pregnancy (Cho et al, 2018).

A history of GDM is shown to have significant implications for long term health, those affected face an 8–10 times greater risk of developing T2DM (Adam, 2023) and a two-fold higher risk of future cardiovascular events (Kramer et al, 2019). Incidences of GDM and T2DM are increasing worldwide, resulting in huge healthcare and economic costs (Bellamy et al, 2009).

Due to these associated risks it is advisable to conduct follow-up screening after a pregnancy complicated by GDM. In the United Kingdom, National Institute of Clinical Excellence guidelines (NG3) (2020) recommended that women with GDM should have post-natal screening for T2DM. These guidelines stipulate women should have a Fasting Blood Glucose (FBG) test at 6-13 weeks post-natal, or an HbA1c or FBG test done after 13 weeks post-natal, repeated annually for life. It also provides recommendations for appropriate referrals to the National Diabetes Prevention Programme (NDPP) depending on results.