Background Women with Type 1 Diabetes (T1DW) and Type 2 Diabetes (T2DW) carry risk of poor maternal and neonatal outcomes. Women are encouraged to report their BGLs weekly and attend antenatal clinic (ANC)
Methods: Retrospective analysis of T1DW and T2DW who delivered at Gosford hospital from May 2014 to March 2019.
Results: There were 43 T1DW with 41 babies and 45 T2DW with 40 babies.
The mean gestation of first contact was 12.2 ± 6.9 weeks in T1DW vs. 13.8 ± 9.1 for T2DW.
7 (16.2%) T1DW used insulin pump therapy with Continuous Glucose Monitoring and 28 (62%) T2DW required insulin at some stage during pregnancy. All T2DW engaged with the program whereas 2(4.6%) T1DW had zero contact with the program and were solely reviewed in the ANC.
All women came for clinic review averaging 8 visits for T1DW and 7 visits for T2DW. 18.6% T1DW vs. 31% T2DW consulted a dietitian.
Mean reduction in HbA1c was 1.4% in T1DW vs. 1.9% in T2DW. Average third trimester HbA1c was 6.7% ±0.97 vs. 5.7% ± 0.96 in T1DW vs. T2DW.
In T1DW v T2DW there was no neonatal hypoglycaemia (NH) in 7 (17%) v 22 (17.5%); 3 (7.3%) v 10 (25%) had moderate NH; 27 (65%) vs. 9 (22.5%) had severe NH.
In T1DW with severe NH, 19.5% had 100% contact vs. 12.2% had 50-100% contact vs. 36.4% had less than 50% contact. In T2D 12.5% had 100% contact, 5% had 50-100% contact, and 5% had less than 50% contact.
Rates of macrosomia for T1DW vs T2DW with 100% contact was 1/41 vs. 4/40; with >50% was 3/41 vs. 2/40; with <50% was 2/41 vs. 2/40. 2/41 vs. 1/40 in T1DW vs. T2DW had shoulder dystocia. All three women had <50% contact with the service.
Conclusion: Women who had greater contact with service had less rates of NH in both T1D and T2D. Further emphasis on techniques of engagement is needed.