P280 Impact of introducing an intensive support package alongside continuous glucose monitoring on neonatal outcomes and...
Published Date: 25th April 2023
Publication Authors: Milne R, McNulty S, Pankaja S, Davies H, Gallagher CG, Christian S, Bujawansa S
Aims
The National Diabetes in Pregnancy Audit in 2020 demonstrated that the percentage increase of women with type 1 diabetes under our service achieving an HbA1c <48mmol/mol between the first and third trimesters was only 12%. This was much lower than the regional and national figures.
To improve this, we introduced an intensive support package consisting of a band 7 Diabetes Specialist Nurse dedicated to antenatal care, intensive dietetic input, weekly appointments, telephone support when needed, and longer 40 min clinic appointments (previously 15 min) alongside provision of CGM for all pregnant women with type 1 diabetes.
We aimed to establish whether this intervention:
- Increased the number of women achieving an HbA1c <48mmol/mol in the third trimester.
- Improved neonatal outcomes.
Methods
Electronic records of 40 women with type 1 diabetes who accessed our service before the introduction of this intervention (n = 20) and after (n = 20) were reviewed and relevant data extracted.
Results
Number of women achieving a third trimester HbA1c <48mmol/mol increased from 15% to 50%, with only 10% of women having a first trimester HbA1c <48 in both groups. Prior to this intervention, 25% of babies were admitted to the neonatal unit at birth in comparison to 10% after. It was also noted that foetal birth weight was reduced by 6% and the incidence of macrosomia (birthweight >4000 g) reduced by 35% after this intervention.
Conclusion
The provision of CGM alongside an intensive support package improved maternal and foetal outcomes in pregnant women with type 1 diabetes.
Milne, R; McNulty, S; Pankaja, S; Davies, H; Gallagher, C; Christian, S; Bujawansa, S. (2023). P280 pact of introducing an intensive support package alongside continuous glucose monitoring on neonatal outcomes and on glycaemic control of pregnant women with type 1 diabetes: A single-centre retrospective study. Diabetic Medicine. 40(Suppl 1), p.150. [Online]. Available at: https://doi.org/10.1111/dme.15048 [Accessed 11 July 2023]
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