What is specialized care?

• Specialized services aim to deliver timely, high-quality care that addresses pregnancy and diabetes care and their interrelated effects in pregnancy, over and above routine antenatal care. Specialized care may include a multidisciplinary team that integrates diabetes and antenatal care, with systems established to facilitate communication between team members. Who provides specialized care?
• The team may comprise experts in different aspects of care that are known to be effective for pregnant women with diabetes (such as an obstetrician, endocrinologist/diabetologist, maternal fetal medicine specialist, pharmacist, midwives, specialist nurses, a nutritionist/dietician, exercise specialist, psychologist, counsellor, etc.), and may connect with other local services as needed (e.g. social work). Care may be coordinated through case conferences, digital care platforms or other available mechanisms. Setting
• In some settings, specialized care may be provided at a local/regional centre that is not co-located with routine antenatal services. Some provision may be possible via telehealth. In some contexts, standard care for pregnant women with type 1, type 2 or GDM may already be somewhat specialized. Aims of specialized care
• Although this list is non-exhaustive, specialized care may aim to:
• provide education and psychological support to the pregnant woman to manage her diabetes during pregnancy; – support the woman in monitoring blood glucose;
• support the woman in maintaining target glucose levels;
• effectively manage the use of insulin and/or oral glucose-lowering agents in pregnancy;
• provide individualized dietary and activity advice, education and support;
• undertake and respond to appropriate fetal surveillance.