PD544 - COMPLIANCE WITH MEDICAL NUTRITION THERAPY GUIDELINES FOR HYPERGLYCEMIA IN PREGNANCY IN A TERTIARY MATERNITY HOSPITAL IN SRI LANKA - A CLINICAL AUDIT

PD544

COMPLIANCE WITH MEDICAL NUTRITION THERAPY GUIDELINES FOR HYPERGLYCEMIA IN PREGNANCY IN A TERTIARY MATERNITY HOSPITAL IN SRI LANKA - A CLINICAL AUDIT

M. Koottage^1,*, R. Prathapan², T. Samarasekara³

¹National Hospital of Sri Lanka, ²De Soysa Maternity Hospital, ³District General Hospital Negombo, Colombo, Sri Lanka

Rationale: Medical nutrition therapy (MNT) is central to managing hyperglycemia in pregnancy (HIP), yet its implementation may be inconsistent. This audit assessed adherence to national guidelines and identified gaps in care.

Methods: A prospective cross-sectional audit was conducted over one month (October 2025) in selected obstetric wards and the antenatal clinic of a tertiary maternity hospital. Women newly diagnosed with HIP were recruited consecutively. Data were collected from records and interviews using a structured tool. Compliance with seven criteria based on national guidelines was analyzed descriptively.

Results: Twenty-five women were included (80% gestational diabetes mellitus, 20% diabetes first recognized in pregnancy). MNT was initiated in all patients (100%). However, only 72% received care from a trained nutrition professional, and 72% had an individualized diet plan. Full continuation until delivery was documented in 32%. Advice on low glycemic index diets was given to all, whereas only 20% were advised to avoid prolonged fasting (>10–12 hours). Follow-up at a nutrition clinic occurred in 24%. Only 2 of 7 standards were met.

Conclusion: While MNT initiation and basic dietary advice were consistent, important gaps remain in specialist input, continuity, and follow-up. Strengthening referral pathways, multidisciplinary care, and documentation may improve adherence to guidelines.

References:         1.  Sri Lanka College of Obstetricians and Gynecologists. Hyperglycemia in Pregnancy: National Consensus Document. Colombo: SLCOG; 2017.

        2.  Management of diabetes in pregnancy: Standards of care in diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S306–S320. doi:10.2337/dc25-S015

        3. Bandara JMRP. Gestational Diabetes: A Temporary Diagnosis with Lasting Consequences. Sri Lanka Journal of Medicine 2025;34(1):1–2; doi: 10.4038/sljm.v34i1.605.

Disclosure of Interest: None declared