The National Diabetes Services Scheme (NDSS)* Diabetes in Pregnancy National Development Program aims to address the need to improve pre-pregnancy planning and care in women with pre-existing diabetes.

To identify strategies and guide project activities, extensive health professional consultation was undertaken. This included administration oftheNDSS Contraception, Pregnancy and Diabetes Health Professional Survey,a 37 item self-administered online questionnaire. Data collected included pregnancy and diabetes knowledge, preconception counselling practices, barriers to preconception care, continuing education needs, and gaps in available information and resources for health professionals.

408 multidisciplinary health professionals, including diabetes educators (33%), dietitians (26%), midwives (13%) and general practitioners (11%) participated in the survey. Preconception counselling was provided towomen with diabetes by 79% of respondents, which includedthe need to use contraception (62%), contraceptive choices (39%), the need for pre-pregnancy planning (72%), reasons why pregnancy should be planned (70%) and how to plan for pregnancy (55%). Respondents believed it was predominately the role of the General Practitioner (92%) or Credentialed Diabetes Educator (81%) to discuss contraception and pregnancy. The main barriers to starting this conversation were lack of available time (49%) and other diabetes management issues taking priority (38%). Half of all respondents (50%) did not have systems in place to remind women of the need to plan for pregnancy, 20% utilised patient education checklists, 9% had protocols for discussing contraception/pregnancy and 6% had reminder systems. Only 8% of health professionals believed that ‘all women’ of childbearing age with diabetes in their service were regularly being reminded of the need to plan and prepare for pregnancy. Health professionals rated highly overall in the knowledge questions, with the exception of current folate recommendations (18% correct).

The survey findings demonstrate a need for strategies to engage health professionals in promoting pre-pregnancy planning and care. Health professionals from multiple disciplines need to have access to appropriate information and resources. The NDSS Diabetes in Pregnancy Program will be addressing these findings and implementing strategies to support health professionals in the management of pregnancy and diabetes. The NDSS is an initiative of the Australian Government administered by Diabetes Australia.