The Leeds Teaching Hospitals NHS Trust

Leeds Maternity Care

Diabetes Specialist Midwives

Welcome to the Diabetes Specialist Midwife Team

Debbie Morris 07768 466010

Jenny Roddy   07799 893132

Julie Meyers  07786 250558

Team Leader: Shelley May s.may5@nhs.net

Matron: Julie Holmes, email: Julie.holmes@nhs.net 

Link Obstetrician: Dr Medha Rathod

We are a team of 3 Midwives who care for women in Leeds that have diabetes and are pregnant. We offer complete case load midwifery care for women with type 1 and type 2 diabetes.

Our clinics are held at St James's Hospital every Wednesday and Thursday afternoon.
We facilitate parentcraft talks in the clinic waiting area - we cover topics such as preparing for birth and parenthood, including a diabetes section.

We coordinate pregnancy care on an individual basis and work closely within a multi-disciplinary team to ensure you receive a high standard of care and good continuity of carer. The Diabetes multidisciplinary team consists of Diabetes Midwives, Maternity Support Worker, Obstetric Consultants, Diabetes Consultants, Dieticians and Diabetes Nurses.

If you have Type 1 or type 2 diabetes you will a combined obstetric/diabetic clinic at frequent intervals throughout your pregnancy, these clinics are held on a Thursday. If you have gestational diabetes our team will support the care you will receive in antenatal clinic at St James on a Tuesday or a Wednesday.

We are continually striving to improve our service by undertaking regular audits, listening to patient feedback and working alongside an award winning research team within our clinics.

Diabetes is a disease when the body is unable to produce or respond to the hormone Insulin, which can result in high levels of glucose (sugar) in the blood.

Diabetes 

There are 3 main types of diabetes

  • Type 1 -  This is a lifelong condition where body produces little or no insulin 
  • Type 2 - Develops when the body doesn’t use or produce insulin properly
  • Gestational diabetes - Diabetes that occurs in pregnancy and usually disappears after baby is born.

Gestational diabetes is a type of diabetes that is seen in pregnancy only.

Gestational Diabetes usually develops 24-28 weeks of pregnancy.

It happens because your body cannot produce enough insulin (a hormone that helps to control blood glucose) to meet the extra needs of pregnancy. This results in high blood sugar levels (blood glucose).

Gestational Diabetes usually resolves after your baby is born.

Pre-Existing Diabetes

As soon as you discover you are pregnant then we would like for you to arrange an appointment for you to be seen within the Diabetes/Antenatal Clinic as soon as possible.

The sooner you attend the diabetes clinic the sooner the Diabetes Team can start ensuring you are receiving the most appropriate care for your early pregnancy needs and optimizing your blood glucose levels.

As soon as you discover you are pregnant then we would like for you to arrange an appointment for you to be seen within the Diabetes/Antenatal Clinic as soon as possible.

The sooner you attend the diabetes clinic the sooner the Diabetes Team can start ensuring you are receiving the most appropriate care for your early pregnancy needs and optimizing your blood glucose levels.

 It is usual for blood glucose levels to become disrupted with the new pregnancy hormones and these may cause your levels to be more difficult to control

If you are taking insulin you may find your hypo awareness symptoms are reduced or disappear for the first few months of pregnancy - therefore it is even more important for you to check your Blood Glucose levels more frequently and always carry with you some food/drinks to correct any hypos you may have. It is important you are aware of this when exercising or bathing alone to ensure your safety.

For more information please see the links below:

https://abcd.care/dtn/flash-glucose-monitoring

https://abcd.care/dtn/cgm

 

Gestational Diabetes 

At your booking appointment with your Midwife, you will be assessed as to whether you have any risk factors for Gestational Diabetes. If you do we would recommend you have a Glucose Tolerance Test to see if you have gestational diabetes. 

Risk factors for a Glucose Tolerance Test after your Dating Scan at approx. 12 weeks

  • Previously Gestational Diabetes
  • Hba1c (Diabetes Blood Test) ≥ 42-47 mmols 

Risk factors for a Glucose Tolerance Test at 24 - 28 weeks

  • Raised BMI over 30
  • Previously had a baby weighing over 4.5kg
  • Parent or sibling with Diabetes
  • Family origin from South Asia, Black African Caribbean or Middle East (even if you were born in the UK)
  • Negative GTT if tested at 12 weeks - repeat at 26 weeks

What happens at a Glucose Tolerance Test (GTT) appointment:

  • You must be Nil By Mouth after midnight apart from plain water to drink, no smoking or chewing gum.
  • A sample of blood is taken on arrival to the Antenatal Clinic.
  • You will be given a measured amount of a 300 ml of a sugary drink to drink over 5 - 10 minutes. 
  • It is important you remain seated in the department until second blood sample taken 2 hours after you had the sugary drink
  • If your GTT result is positive we will ring you within 5 working days, please make sure the clinic have up-to-date contact details so we can contact you
  • If your GTT result is negative your midwife will inform you at your next antenatal appointment.

What to expect if you have Gestational Diabetes

You will be contacted by our team and invited to a group antenatal session where we will discuss what it means to have gestational diabetes and discuss your plan of care.

You will need to check your blood glucose levels 4 times a day at the following times for the remainder of your pregnancy: 

  • Fasting, (before breakfast)
  • One hour after your breakfast
  • One hour after your lunch
  • One hour after your evening meal

You will be provided with a diary for you to write your blood glucose results in. For more information about blood glucose testing please follow this link. 

 An individual management plan will be made with you and include timing of your baby's birth.

  • When you come in to Hospital for any reason , it is important you bring your Blood Glucose monitoring kit and any medication you are taking in with you
  • Once baby is born you can stop monitoring your blood glucose levels.
  • Your baby will need their blood glucose levels monitoring when they are born, this is done by a small heel prick blood test at certain intervals
  • We recommend at least a 24 hour stay in hospital to ensure all is well with baby before discharge