Author(s): Palmer J.; Alabraba V.; Clarke G.; Ford N.; Kelly C.; Samad S.
Source: Diabetic Medicine; Mar 2019; vol. 36 ; p. 112-113
Publication Date: Mar 2019
Publication Type(s): Conference Abstract
Available at Diabetic Medicine – from Wiley Online Library Full Collection
Abstract:Aims: This study aimed to explore whether factors in primary care impacted on why women across Liverpool were not receiving adequate preconception care. Our regional NPID data highlighted poor preconception HBA1C and folic acid use. Local data identified that only 36.7% of patients with diabetes in one local antenatal service had any preconception counselling and that 46.7% were under primary care services only at the time of conception. Method(s): A questionnaire, circulated to 30 GPs and Practice Nurses across Liverpool, was designed to assess the level of knowledge of risks associated with diabetes and pregnancy, who and how to refer pregnant patients or those planning pregnancy, and also what interventions may improve management of these patients. Result(s): Despite 60% of respondents stating they were aware of the risks, only macrosomia was commonly identified (60%). Only 10% identified any first trimester risks and there was a poor understanding of medication management. 30% identified better glycaemic control and also early referral as important but there was confusion over how to access preconception and antenatal services. Conclusion(s): The questionnaire demonstrated a need for education in primary care around the risks associated with becoming pregnant with suboptimal glycaemic control and that perhaps a lack of knowledge with regards to first trimester risks and who to refer the patient to, was leading to poor local conception HBA1C values. There is a need for a concise pathway for referral into preconception clinics and antenatal clinics when, where and how.