Pre-pregnancy care for women with Type 2 diabetes (PREPARED)
Research type
Research Study
Full title
An Integrated Primary Care-based Programme of Pre-pregnancy Care to Improve Pregnancy Outcomes in Women with Type 2 diabetes: A Multi-method Study of Implementation, System Adaptation and Performance.
IRAS ID
297153
Contact name
Angus Forbes
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Develop and iteratively refine ways to improve access for women with Type 2 diabetes to pre-pregnancy care and reduce pregnancy complications and costs.
Background
In the UK half of all pregnancies in women with pre-existing diabetes occur in women with Type 2 diabetes. These women have a higher risk of miscarriage, stillbirths, or birth defects as well as caesarean deliveries and their infants being admitted to special care baby units.Most women with Type 2 diabetes are unaware of these risks and currently only 10% receive pre-pregnancy care in line with NICE guidance which recommends optimising blood sugars levels; stopping harmful medications; and adding high-dose folic acid. Improving access to pre-pregnancy care for women with Type 2 diabetes is a high priority.
We reviewed previous pre-pregnancy care studies and talked to women and health professionals to identify barriers to this care and how to overcome them. Currently pre-pregnancy care is hospital based, therefore disconnected from where most women with Type 2 diabetes receive care. We developed a package of primary care-based help including:
• Instructions about what care women with Type 2 diabetes should receive.
• Training for doctors and nurses including guidance on what to do, and when.
• Information for women
• Recording mother and baby information to see if the help made a difference.Study methods
We will monitor if the new ways of working make a difference to women with Type 2 diabetes, and their baby’s health.
We will collect information, make changes if we find something works better, or not.
We will ask women and health professionals their view of changes and how best the NHS could include these.Outcomes
The development of a programme of interventions to improve pregnancy preparation and reduce adverse pregnancy outcomes. We will develop an implementation plan to support this care across the NHS.REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
21/LO/0823
Date of REC Opinion
3 Dec 2021
REC opinion
Favourable Opinion