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Gestational Diabetes -Quality improvement project of postnatal review clinic

Venkatram NAVANEandHA KRISHNAN, Thanushree VENKATRAM, Liam NICHOLSON and Mayukh BHATTACHARYYA

NICE recommends women who were diagnosed with gestational diabetes and whose blood glucose levels returned to normal after the birth: offer lifestyle advice (including weight control, diet and exercise. After 13 weeks offer a fasting plasma glucose test or an HbA1c test if a fasting plasma glucose test is not possibleMethods : 40 patients notes were retrospectively reviewed by giving random numbers out of 133 patients.Aim : To assess BMI and HbA1c was ordered or carried out at postnatal review as per guidelines by 13 weeks after delivery . To assess BMI was calculated for prevention of obesity related disordersResults : 49% patients had Hba1c completed and reviewed as per guidelines. 58% patients had BMI calculated at postnatal check. The mean BMI was 29.7 +/-4.4 kg/m2.Our patients are mainly ethnic minority immigrant group where there is high prevalence of Type2 diabetes. This project showed we need to improve our monitoring of gestational diabetes review to prevent future diabetes and obesity related disorders.We have introduced warning messages in patients records as reminder for clinicians We had a training for monitoring/coding team to order blood test and use text messages as reminder for patients.   References: Diabetes in pregnancy: management from preconception to the postnatal period: NICE guideline; Reference number:NG3 Published: 25 February 2015. Last updated: 16 December 2020