The West Midlands Diabetes in Pregnancy report, ‘Diabetes
in Pregnancy: addressing the challenge in the West
Midlands’ highlights and identifies key findings to
improve clinical care and pregnancy outcomes for
women in this group.
The NICE clinical guideline 63 (March 2008) states;
- Most women who have diabetes or develop diabetes
in pregnancy have healthy pregnancies and healthy
babies. However, they may sometimes have serious
problems, so it is important that they receive
the extra care and support to ensure that they
- If you have diabetes and are planning to become
pregnant, or are already pregnant and have diabetes
or develop diabetes, your healthcare team should
provide information, advice and support to help
you manage your diabetes and reduce the risks to
you and your baby.
About the project
The DiPAG Patient Information Leaflet subgroup came
into being in January 2009 to scope tasks to produce
leaflets for healthcare professionals working within
Diabetes-Pregnancy teams. The aim was to make available
a resource for all women with diabetes in pregnancy
and/or planning pregnancy.
The information detailed in the leaflets have been
developed to be used as part of individualised care
plans and ongoing advice offered by healthcare professionals.
It is important for women to access and meet
with their local Diabetes/Maternity Teams when
using these leaflets.
The aim is to improve preparation for pregnancy
and improve pregnancy outcomes by offering relevant
information tailored to individual needs.
Leaflet Development Team
|Dr. Peter Davies
||Consultant in Diabetes & Endocrinology,
Hon Senior Clinical Lecturer,
Sandwell Hospital, Sandwell and West Birmingham NHS Trust
||Diabetes Project Midwife
Perinatal Institute, Birmingham
|Sr Jagjit Dhallu
||Diabetes Specialist Nurse,
Sandwell Hospital, Sandwell and West Birmingham NHS Trust
Advanced Dietitian for Maternal
Birmingham Community Nutrition & Dietetic Department
Midwife and Baby Friendly Coordinator,
City Hospital, Sandwell and West Birmingham NHS Trust
|Dr. Krish Nirantharakumar
Specialist Registrar in Public
University of Birmingham
|Dr. Vinod Patel
Clinical and Social Care Lead LTC,
NHS West Midlands,
Hon. Consultant in Endocrinology and Diabetes, Medical Obstetrics,
George Eliot Hospital NHS Trust
Diabetes Specialist Midwife, George
Eliot Hospital NHS Trust
|Mr. Neil Shah
City Hospital, Sandwell and West Birmingham NHS Trust.
Clinical Lead, Diabetes in Pregnancy Project
Leaflet development and evaluation
Eleven leaflets were individually tasked and reviewed
by team members of the subgroup. Relevant amendments
and changes were made at the Subgroup Meetings in
line with guidance sought from both NICE clinical
guideline 63 (March 2008) and the Department of Health
(DOH) NHS Toolkit for providing patient information
Version 2 (2003).
- Do you have Diabetes? Planning a Family?
Key facts you need to know
- Do you have Diabetes? Planning a Family? Things
to DO before you get
- Contraception for Women with Diabetes
During Pregnancy Leaflets
- Healthy Eating
- What is Gestational Diabetes?
- Glucose Tolerance Test
- Diabetes & Breastfeeding
- How to Avoid Hypoglycaemia in Pregnancy?
- Type 1 and Diabetes - ‘Sick Days’ What
to do if unwell
- Metformin Treatment in Pregnancy
The subgroup recognised that both General Practitioners
and Lay representatives were unable to contribute
during the development stages of these leaflets.
For this reason, prior to commencement of a pilot
we sought to include viewpoints and comments from
both parties, amending each leaflet accordingly.
The pilot of the eleven leaflets was undertaken
in five West Midland Maternity Diabetes units and
three General Practices (1st February – 31st March
- Birmingham Women’s
Hospital Foundation Trust /University Hospital
group of Hospitals
- George Eliot Hospital NHS
of England Foundation Trust
- Sandwell and West
Birmingham NHS Trust
3 General Practices
- South Birmingham
(20 leaflets each)
unit was issued with five copies of each of the eleven
leaflets. The South Birmingham General Practice received
five copies of four of the leaflets relevant to the
primary care setting. Two General Practices within
Sandwell and West Birmingham NHS Trusts utilised
circulated leaflets relevant to the primary care
To assess feedback and evaluate comments regarding
the effectiveness of each leaflet, every leaflet
pack contained two individualised questionnaires
for completion by the healthcare professional and
by the woman, each returned separately in pre paid
self addressed envelopes.
Respondents from the HCP were asked to comment upon
their impression on individual leaflets; their usefulness,
clear and understandable and whether they would use
them within clinical practice.
The women were asked if they understood the information
from the amount of detail given and their overall
We received responses and comments pertaining to
34% of healthcare professionals (HCP) responded.
These included Associate Specialists, Diabetologists,
Dietitians, Diabetes Specialist Nurses, Midwives,
Diabetes Specialist Midwives, Interpreters, Obstetricians,
Specialised Midwifery Assistants, Practice Nurses,
and a Nursery Nurse.
20% of women (type 1, type 2 and gestational
diabetes) asked to participate returned questionnaires.
age range of respondents was 21 – 45years (median
age 30 years). There was a spread of ethnicity
recorded (European, African, Afro-Caribbean, East
South Asian and Other), with 48% stating this was
Additional subgroup meetings occurred to discuss
comments for individual leaflets to identify areas
to either accept or reject changes. 75% of the suggestions
raised led to alterations. Some were minor but significant
and others more detailed. As a result all the leaflets
were found to be acceptable with only one leaflet
being specifically tailored to women with type 1
The leaflets are free to access from this website.
DiPAG is currently investigating the possibility
of producing printed versions of each leaflet which
can be ordered through the Perinatal Institute. Please
refer to this website for further details regarding
We would like to thank all the women and the health
professionals who participated in the pilot for taking
time to complete the questionnaires. We greatly appreciate
all comments received, which were significant
in the evaluation and modification for all the
Diabetes Project Midwife