Results. A total of 261 pregnancies were included: 112 pre-intervention and 149
managed under the nurse practitioner-led model. There were 37 women with preexisting
diabetes (26 T1DM, 11 T2DM) and 195 with gestational diabetes.
Referrals to dieticians and diabetes educators increased, while referrals to
physicians decreased. There was no decrease in the risk of adverse maternal
outcomes for all women with DIP or women with GDM. However, there was a
24% decrease in adverse neonatal outcomes overall and a 40% decrease among
infants of women with gestational diabetes.
Conclusion. The study demonstrated that nurse practitioner-led models of care
for diabetes in pregnancy are feasible. The findings suggest that the model
reduced adverse neonatal outcomes. By improving information provision, support
and care coordination, the model is particularly valuable in rural areas, where
access to medical specialists is often restricted.