To explore whether and in what way local Gestational Diabetes Mellitus (GDM) guidelines in England differed between themselves and from NICE guidance.

Design: Qualitative observational comparison of local hospital GDM guidelines.

Local guidelines were requested via email from 62 English hospital Trusts with follow-up emails to non-responders. Guidelines were compared on key aspects of diagnosis, antenatal and intrapartum management and long-term diabetes testing.

Further research would be needed to see what effect variation in local guidelines has on the diagnosis and treatment of GDM in local populations.

Guidelines were reviewed from 13 Trusts across ten counties.  All included the NICE recommendations for GDM testing and management. 

Antenatal care: 4/13 did not specify further support unless there was poor glycaemic control; 1/13 offered contact details for a specialist nurse; 7/13 organised appointments with either a specialist nurse or an MDT.  Only one hospital specified counselling with a specialist at 36 weeks pregnancy to discuss a birth plan. 

Deivery: recommendations varied for maximum gestation before induction (37+0 - 40+6 weeks), maternal blood sugar testing in labour, and treatment plans during and after birth.

Postnatal: some hospitals arranged annual HbA1c while others simply recommend it

Approval: This study was registered as a service evaluation with Leeds Teaching Hospitals NHS Trust.     Acknowledgements: With thanks to all of the staff who assisted with this evaluation