Preconception care of women attending adult general diabetes clinics--are we doing enough?

Diabetes Res Clin Pract. 2007 Apr;76(1):142-5. doi: 10.1016/j.diabres.2006.07.025. Epub 2006 Sep 6.

Abstract

Background: The presence of diabetes in pregnancy can result in substantial morbidity to both mother and baby if management is sub-optimal.

Aims: To assess the process of standards of preconception care (against the National Service Framework standards) of women attending the adult general diabetes clinics in a district general hospital.

Methods: Retrospective review of case notes of women aged 18-40 years attending the general diabetes clinics for annual review, over a period of 6 months.

Results: Seventy sets of notes were reviewed. The mean age of the patients was 32 years. Fifty-six patients had type-1 diabetes and 14 patients had type-2 diabetes. Mean duration of diabetes was 13 years. Eighty-six percent of the patients had blood pressure recordings documented. Mean blood pressure was 124/74 mmHg. Mean HbA1c was 9.1%. Documented evidence of home blood glucose monitoring was seen in 66% of the patients. Preconception counselling/contraception were discussed in 17 patients (25%). Twenty-nine patients (41%) were on potentially teratogenic medications. Alcohol and smoking history was not documented in 91% and 61% of the patients, respectively.

Conclusions: This retrospective assessment highlights that reproductive issues in an at risk population of women with diabetes are not included in routine management of diabetes care in outpatient clinics.

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring / instrumentation
  • Blood Glucose Self-Monitoring / methods
  • Blood Pressure
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Glycated Hemoglobin A / analysis
  • Hospitals, District
  • Humans
  • Hypertension / etiology
  • Hypertension / prevention & control
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / methods
  • Outpatient Clinics, Hospital*
  • Preconception Care
  • Pregnancy
  • Pregnancy in Diabetics / blood*
  • Retrospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin A