Diabetes in Pregnancy: Standards of Care and Clinical Pathway Development

In 2013, the DON SCN began working on developing standards when caring for mothers with diabetes and their babies.

Gestational Diabetes (GDM) is glucose intolerance first recognized during pregnancy. It typically occurs after 20 weeks into a pregnancy.

  • Approximately 4 per cent of pregnant women develop GDM.
  • In Alberta, the number of GDM cases doubled from 710 in 1999 to 1,420 cases in 2009.
  • GDM is known to increase the risk for later development of type 2 diabetes and cardiovascular disease for both the mother and child.
  • GDM increases the risk of the woman developing type 2 diabetes later on by 50 – 60 per cent.

The DON SCN has established a network of researchers, clinicians and decision-makers who are working together to gather the best evidence on how to care of GDM, ensure all care providers across the province are following the same standards of care and improve the health of moms and their babies.

Some of the work underway currently includes:

  • Exploring the differences in care and management of mothers and babies during labor and delivery across Alberta. For example, caesarean sections are more common with GDM and as such, so are NICU admission for the babies. Research is underway to gather evidence in this area and determine if changes should be made to clinical practices.
  • Improving post partum screening of mothers with GDM for Type 2 diabetes: Clinical practice guidelines recommend screening for type 2 diabetes within six months of delivery, and annually thereafter. In Alberta, less than 50 per cent of mothers who had GDM are screened for type 2 diabetes post partum. By researching and understanding the barriers to this important screening we will be able to develop, test and implement ways to improve post partum screening rates.