Management
Women diagnosed with GDM were seen around twice in the diabetes antenatal clinic after their diagnosis (median, 2; IQR, 1-4). Approximately half of women with GDM (49.8%) received lifestyle advice only, 19.4% received low dose metformin (≤1g/day), 1.7% received higher dose metformin (>1g/day) and one woman received insulin as a twice daily premixed preparation. Only one woman, who was treated with insulin, performed home self-monitoring of blood glucose. Half of the women with GDM (49.8%) had <2 fasting glucose measurements documented during antenatal follow-up. Of the remaining, around half appeared controlled (mean of 2 fasting blood glucose values <5.1 mmol/L) and half appeared either partially controlled (mean of 2 fasting blood glucose values 5.1-7.0 mmol/L) or uncontrolled (mean of 2 fasting blood glucose values >7.0 mmol/L). Few women (15.6%) had documentation of a third trimester ultrasound scan. A summary of the diabetic management of women with GDM is shown in the Supplementary Appendix (Table S4).