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Protocols for Pre-existing or Gestational Diabetes in Pregnant and Postpartum Women

Protocols for Pre-existing or Gestational Diabetes in Pregnant and Postpartum Women

1. What is the decision or change you are facing or struggling with where a summary of the evidence would be helpful?

Question: What are the benefits to implementing standardized intrapartum and postpartum protocols for women with preexisting or gestational diabetes.

Population: Pregnant and postpartum women with preexisting or gestational diabetes.

Intervention and Comparator:

  1. Intravenous glucose management therapies and intrapartum glucose levels AND
  2. Oral or parenteral glucose management therapies and postpartum glucose control

Outcomes:

  • Patient outcomes: Maternal hyperglycemia significantly increases the risk of maternal and neonatal morbidity and mortality.
  •  Individual and institutional costs: Chronic conditions such as diabetes are major contributors to overall healthcare costs and comprise the 3rd leading cause of pregnancy-related death in the United States (CDC, 2021).

Maternal pregnancy complications comprise the 3rd leading cause of infant death in the United States (CDC, 2020). Uncontrolled maternal diabetes is likely to increase lengths of hospital stay, medical costs, and maternal and newborn postpartum hospital readmission rates.

(CDC, 2021).
(CDC, 2020).

2. Why are you struggling with this issue?

There are few standardized practices targeted specifically to meet the needs of pregnant and postpartum women with diabetes. There is a paucity of evidence-based protocols targeted to pregnant women as they are not typically included in clinical trials. There is a variation in therapeutic medication management.

3. What do you want to see changed? How will you know that your issue is improving or has been addressed?

We would like to provide clinicians with standardized algorithms or tools for the management of women with diabetes in the intrapartum and postpartum periods, based on the best available evidence. Development and implementation of more universally accepted and standardized management protocols can result in more consistent glycemic control and improved maternal and neonatal outcomes.

4. When do you need the evidence report?

Wed, 06/01/2022

5. What will you do with the evidence report?

Develop and publish evidence-based clinical practice guidelines based on the findings of this report. Evidence-based guidelines will facilitate and guide the implementation and testing of standardized protocols. Patient education tools may be derived from guideline development.

(Optional) About You

What is your role or perspective? National Nursing Organization

If you are you making a suggestion on behalf of an organization, please state the name of the organization: Association of Women's Health, Obstetric and Neonatal Nursing (AWHONN)

May we contact you if we have questions about your nomination? Yes

Page last reviewed June 2021
Page originally created June 2021

Internet Citation: Protocols for Pre-existing or Gestational Diabetes in Pregnant and Postpartum Women. Content last reviewed June 2021. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/protocols-pre-existing

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