Endocrine Abstracts

Introduction: Pregnancy under the age of 19 is considered high-risk¹; and a pregnancy with diabetes at this age further increases that risk^2,3. With the correct advice and counselling, these risks can be greatly reduced. Here we describe a strategy to raise awareness by addressing this as part of regular clinic visits.

Method: Prior knowledge of potential complications of pregnancy was assessed as part of a clinical consultation. Evidence-based resources in the form of articles^4,5,6 were then provided and the learning was reassessed and incorporated into the next consultation with MDT input in a caring and supportive manner. For efficiency and ease of data processing, this was facilitated through use of a multi-choice questionnaire linked via a QR code. Knowledge before and knowledge after teaching was then compared. https://docs.google.com/forms/d/e/1FAIpQLSedyyoWkxRaCiq3BNd4pPlfCrc4aa0pJx8ce4wwnYT6iYV4Yw/viewform

Preliminary results: The study included 5 young people with diabetes (n=5) and was extended to 10 young people without diabetes, so knowledge could be compared between cohorts (total n=15). All reported they would like to know more about diabetes and pregnancy, and only one said they were able to discuss anything about the topic. The preferred style of delivery was either articles or outside speakers for the group with diabetes, and videos for those without. Most felt any form of contraception was acceptable and underestimated the incidence of unplanned pregnancy. Only one person correctly guessed the extent of complications, while the majority underestimated the impacts. From a list of 10 possible complications, only 3 were correctly identified. Additional supplementation was inferred by less than half and only one person knew the correct daily dose. Pregnancy targets for HbA1c and time in range were little understood and nobody knew the target at which a pregnancy is ill-advised.

Conclusion: There is a clear need for education on this topic in populations with and without diabetes. A preconception counselling teaching pack incorporating feedback on preferred learning styles has now been assembled for use during clinic and the project will be extended across our wider Trust which includes over 100 adolescents; the impact of which will be reported at conference.

References

On request