Ambulatory care for women with gestational diabetes in Germany Gestational diabetes from the perspective of practices specializing in diabetes

Almost 60,000 pregnancies in Germany were affected by gestational diabetes in 2021 (about 1 in 13). Screening, diagnostics, therapy, and follow-up care require continuous good interdisciplinary communication between obstetric practices, practices specializing in diabetology, midwives, and maternity hospitals. Letters, e-doctor's letters, and insert sheets for the maternity pass can support this process. A healthy, specially adapted diet and sufficient exercise are the cornerstones of treatment. If the metabolic goals are not met with this, insulin treatment is indicated in coordination with the obstetric practice. Pregnant women with insulin treatment or unstable blood sugar levels should deliver their babies in maternity hospitals with a level 1 or 2 perinatal center. Breastfeeding has a positive effect not only on the child's metabolic future, but also on the mother. Postpartum follow-up is key for primary prevention of diabetes and cardiovascular disease. Despite various efforts to increase the proportion of mothers who take part in postpartum diabetes screening, only 40% appear to do so. The lifelong increased metabolic risk of mothers after gestational diabetes mellitus (GDM) must be considered in the aftercare and prevention strategy in gynecological and general practitioner practices. The GestDiNa_basic project examines the current GDM aftercare situation and develops components of a care model for patient-centered aftercare.