To provide quality care to growing numbers of women with gestational diabetes mellitus (GDM) within a resource-limited diabetes service, a new initiative was developed in January 2018 to support increased face-to-face time with diabetes health professionals while women attend their appointments at High Risk Antenatal Clinic (HR-ANC). Prior to 2018 women had regular reviews with the obstetrics team at HR-ANC and saw the diabetes team (endocrinologist, diabetes nurse specialist and diabetes specialist dietitian) as needed. The retrospective audit was preformed to determine whether adding a second diabetes team, diabetes specialist nurse and diabetes specialist dietitian, to the HR-ANC improved the opportunities for increased patient interaction time.
An audit was conducted to assess the in-person contact time women had with diabetes professionals in 2017 compared to 2018. The medical notes of 40 women, 20 each year, were reviewed to calculate the number of face-to-face interactions women had and topics discussed with diabetes team members. Other modalities of contact were excluded.
In 2017 women had an average of 2.3 in-person interactions with diabetes team members during pregnancy. Post implementation, women were seen an average of 3.3 times, a 30% increase from 2017. Topics discussed in 2017 included nutritional management of GDM, weight gain targets and diabetes medication initiation/adjustment. Additional topics addressed in 2018 included micronutrient adequacy, type 2 diabetes risk reduction, postnatal delivery plans and postnatal service referrals.
Conclusions. A second stream of diabetes specialist team members present at weekly HR-ANCs significantly increased the opportunity for diabetes health professionals to have face-to-face interactions with women with GDM, foster discussions about a broader range of relevant health topics, and share more information about future diabetes risk reduction.