Diabetes: gestational diabetes annual HbA1c test

  • NICE indicator
  • IND173
  • Published:
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Indicator

The percentage of women who have had gestational diabetes, diagnosed more than 12 months ago, who have had an HbA1c test in the preceding 12 months.

Indicator type

General practice indicator suitable for use in the Quality and Outcomes Framework.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

The aim of this indicator is to improve the ongoing monitoring of women with a history of gestational diabetes and to ensure that those who go on to develop type 2 diabetes are identified at an early stage and offered appropriate treatment.

Women with a history of gestational diabetes are at increased risk of developing type 2 diabetes, even when glucose levels have returned to normal limits during the initial post-natal period. Current evidence suggests that the rates of follow-up in the form of annual HbA1c testing in this group are low, with the potential for care to be improved (McGovern et al. 2014).

Reference:

McGovern A, et al. (2014) Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study. British Journal of General Practice 64 (618): e17–23.

Specification

Numerator: The number of patients in the denominator who have had a HbA1c test in the preceding 12 months.

Denominator: Women who have had gestational diabetes.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: Women diagnosed more than 12 months ago.

Expected population size: The Office of National Statistics (ONS, 2024) estimates of the population for the UK, England, Wales, Scotland and Northern Ireland, mid-2022 edition (MYE1: summary for the UK, England, females and all persons) show that 51% of people in England are female: of 5,100 per 10,000 patients served by a network. During development (IND173 resource impact assessment) it was estimated that 0.4% of this population has been previously diagnosed with gestational diabetes: 21.9 per 10,000.

During development, it was noted that historically, coding of patients with gestational diabetes has been poor, so prevalence may be greater than estimated.