The rising incidence of gestational diabetes and inconsistent
patient and foetal outcomes in Basingstoke and North Hampshire
Hospital NHS Foundation Trust led to a redesign of its patient
pathway for women with a positive oral glucose tolerance test. All
women with a positive OGTT are invited to an afternoon session
with education delivered by a diabetes nurse, diabetes specialist midwife and dietician. Women are taught
home blood glucose monitoring. Review of monitoring data is carried out in a midwife led clinic that runs
in parallel to our routine joint antenatal/diabetes clinic. A number of benefits have been demonstrated,
with patient-reported outcomes showing the shared learning experience reduced anxiety and became a
positive drive to improve diet and lifestyle. Group education is extremely cost effective and peer support,
standardisation of educational materials and quality control of education are now embedded.
The number of women being diagnosed with gestational diabetes is rising. Women require a
multidisciplinary approach to their antenatal care. Each member of the team seeing patients
individually was not sustainable without reduction in quality of information and support given.
A lack of dietetic time was a main driver to change. The Trust's previous programme tended to
over medicalise the experience and was not always viewed as a positive experience.
To deliver a group education programme for women diagnosed with gestational diabetes with input
from diabetes, obstetrics and dietetics which delivered comparable obstetric and maternal outcomes
to existing program and made best use of the limited resources of our health care professionals.
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