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Gestational Diabetes Mellitus

Useful management information

This information relates to Gestational Diabetes only, a separate referral to antenatal clinic is required (unless GDM is diagnosed early/concurrent with the first antenatal screening tests)

  • First trimester early OGTT (preferred) or HbA1c – if risk factors for gestational diabetes
    • BMI > 30 kg/m2 (pre-pregnancy or on entry to care)
    • Ethnicity (Asian, Indian subcontinent, Aboriginal, Torres Strait Islander, Pacific Islander, Maori, Middle Eastern, non-white African)
    • Previous GDM
    • Previous elevated Blood Glucose Level (BGL)
    • Maternal age ≥ 40y
    • 1st degree relative with DM or sister with GDM
    • Previous macrosomia (birth weight > 4500 g or > 90th percentile)
    • Previous perinatal loss
    • Polycystic Ovarian Syndrome
    • Medications (corticosteroids, antipsychotics)
    • Multiple pregnancy
  • Consider early low dose Aspirin use if risk factors for pre-eclampsia/IUGR are identified.  Commence before 16 weeks and usually ceased at 36 weeks gestation

Clinician resources

Patient resources

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

  • Gestational diabetes mellitus (GDM), or diabetes first recognised during pregnancy. For optimum care, patient should be seen within 1 week at maternity service. 

Note: pregnancy in a patient with existing diabetes require early referral to maternity services

Category 2
(appointment within 90 calendar days)
  • No category 2 [5] criteria
Category 3
(appointment within 365 calendar days)
  • No category 3 [6] criteria

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at Brisbane South HealthPathways
  • Consider other treatment pathways or an alternative diagnosis
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)


Essential referral information for Gestational Diabetes Mellitus referrals (Referral will be returned without this)

  • Essential referral information required as per Antenatal Essential information unless already provided
  • Ethnicity including if interpreter required
  • Diagnostic test result e.g. OGTT, Fasting blood glucose result, HbA1c

Additional referral information for Gestational Diabetes Mellitus referrals

  • Additional referral information as per Antenatal Additional information
  • Past history of GDM and previous management
  • Outcomes associated with previous GDM, e.g. stillbirth, macrosomia, shoulder dystocia, fetal hypoglycaemia
  • Birthweight of previous pregnancies and fetal anomoly
  • Additional relevant investigations, ELFTs, urine protein/creatinine ratio, Fetal Ultrasound
  • Any current BGL data and management

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 24 November 2021