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Patient Information Leaflets

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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 stay well.
  • 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
Sub-Group Chair
Pat Brydon Diabetes Project Midwife
Perinatal Institute, Birmingham


Sr Jagjit Dhallu Diabetes Specialist Nurse,
Sandwell Hospital, Sandwell and West Birmingham NHS Trust
Janet Gordon

Advanced Dietitian for Maternal Health,
Birmingham Community Nutrition & Dietetic Department

Christina Lewis

Midwife and Baby Friendly Coordinator,
City Hospital, Sandwell and West Birmingham NHS Trust

Dr. Krish Nirantharakumar

Specialist Registrar in Public Health ,
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

Judith Plester

Diabetes Specialist Midwife, George Eliot Hospital NHS Trust

Mr. Neil Shah Consultant Obstetrician,
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).


Leaflets Developed

Pre-Pregnancy Leaflets

  • 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 pregnant
  • 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

Post-pregnancy Leaflet

  • Post natal Care for Gestational Diabetes

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 2010).

5 specialist centres

  • Birmingham Women’s Hospital Foundation Trust /University Hospital Birmingham
  • Dudley group of Hospitals
  • George Eliot Hospital NHS Trust
  • Heart of England Foundation Trust
  • Sandwell and West Birmingham NHS Trust

3 General Practices

  • Sandwell
  • South Birmingham (20 leaflets each)

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 setting.

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 impression.



We received responses and comments pertaining to each leaflet.

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. The age range of respondents was 21 – 45years (median age 30 years). There was a spread of ethnicity recorded (European, African, Afro-Caribbean, East Asian, South Asian and Other), with 48% stating this was their first pregnancy.



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 diabetes only.


Next Steps

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 this development.



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 leaflets.


Pat Brydon
Diabetes Project Midwife

© Perinatal Institute 2011