Drs. Veronika Duwel1,2,3, Dr. R. IJzerman1,2, Prof. dr. R. Painter3,4, Dr. Sarah E. Siegelaar1,2.
1) Department of Endocrinology, Amsterdam UMC, Amsterdam; 2) AGEM Research Institute; 3) AR&D Research Institute; 4) Department of Gynecology and Obstetrics, Erasmus MC, Rotterdam.
Introduction: Pregnancies complicated by pregestational diabetes (PGDM) have higher risks compared to healthy individuals and pose unique management challenges. Many countries have established national guidelines outlining PGDM management strategy, as they ensure high-quality care, improving maternal and neonatal outcomes. The aim of this study is to examine current healthcare practices for PGDM management in the Netherlands.
Methods: This cross-sectional survey was conducted among healthcare professionals (HCP) providing maternal (OB) and diabetic care (IM) in 70 Dutch hospitals. Selective sampling was used to ensure representativeness of data. The survey included questions about multidisciplinary collaboration, dedicated PGDM team, protocol use, standard obstetric and diabetes care. Surveys were collected between January-June 2025.
Results: In total, 118 HCPs responded from 68 unique hospitals. Interim analysis (n=92) shows that many hospitals have a dedicated PGDM protocol and a majority reports having a regular multidisciplinary meeting. However, 19.5% IM report no dedicated protocol, and up to 39.2% have no dedicated multidisciplinary team. Almost a third of IM representatives does not refer both Type 1 and 2 diabetics to gynecology for a preconception consult. While 62.7% OB representatives reports seeing on average 1-10 patients for a preconception consult per year, this estimate is lower than the number of reported PGDM pregnancies per year (16.3% 1-10, 29.3% 11-20, and 54.3% more than 20 pregnancies). These preliminary results show potential for improvement. In the next few weeks, the questionnaires will be analyzed in detail.
Conclusion: This is a first comprehensive effort to understand the current care pathways for PGDM in the Netherlands. The preliminary results show many commonalities between standard practice in Dutch hospitals, yet there are clear areas of improvement. This mapping effort is the first step in establishing a unified, multidisciplinary national guideline. During ADDRM 2025 final survey results will be shared.