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ContactImproving Gestational Diabetes Care with the Diabetes Record Information Standard
Background
Gestational Diabetes Mellitus (GDM) affects 1 in 20 pregnancies in the UK, with increasing prevalence. Up to 50 per cent of women diagnosed with GDM develop type 2 diabetes within 5 years of diagnosis with an ongoing elevated risk thereafter. Additionally, GDM disproportionately impacts women from deprived and global majority backgrounds and addressing these gaps in communication between primary and secondary care is crucial for both immediate pregnancy management and long-term diabetes prevention.
Purpose of the project
The Health Innovation Network (HIN) South London piloted the Diabetes Record Information Standard (DRIS) to improve information sharing and care coordination for women with GDM. The project aimed to enhance:
- Immediate care: Ensuring proper medication, glucose monitoring, and continuity of care during pregnancy.
- Long term pathway stability and diabetes prevention: Standardising coding, enabling better follow-up testing, and improving referrals to the NHS Diabetes Prevention Programme (NDPP).
This initiative was conducted across three NHS Trusts in South East London: King’s College Hospital (KCH), St Thomas’ Hospital (STH), and the Princess Royal University Hospital (PRUH).
What we achieved
Through research, surveys, and stakeholder interviews, we identified critical gaps and implemented changes:
Improved GDM diagnosis letter
Based on feedback from GPs, midwives, and diabetes specialists, a redesigned letter was introduced, ensuring clarity, structured formatting, and actionable instructions.
Enhanced coding practices
Issues with SNOMED CT codes were identified, improving the recording of GDM for continuity of care.
Baseline data insights
Analysis of 1,932 GDM pregnancies in south east London (2022) revealed:
- 74% had a recorded GDM code in primary care within six months post-pregnancy.
- 56% underwent an HbA1c test within six months.
- Only 10% were referred to NDPP, highlighting a need for improvement.
Recommendations
To improve outcomes for women with GDM, we propose:
Modifications to DRIS
Including gestational age, history of GDM, and oral glucose tolerance test results.
Better coding practices
Ensuring GDM remains an active record for long-term follow-up.
Improved referral pathways
Automating NDPP referrals and developing tailored postnatal support.
Incentivising follow up care
Including GDM in NHS QoF measures to ensure regular HbA1c testing.
Conclusion
This project has demonstrated that structured communication can significantly enhance the management of GDM, ensuring better patient outcomes and reducing the long-term risk of type 2 diabetes. By embedding these recommendations into national standards, we can improve care for thousands of women each year.
Find out more about our work piloting the Diabetes Record Information Standard in gestational diabetes care and download the full report.
