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Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1269) Postpartum Management and Transition-of-Care for Patients with Type 2 Diabetes

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Coauthor(s)

Alexandra Schroeder, MD (she/her/hers)

Fellow Physician
Saint Louis University Division of Maternal Fetal Medicine
Saint Louis University Department of Maternal Fetal Medicine, Missouri, United States

Submitting Author and Presenting Author(s)

Spencer R. Pope, DO (he/him/his)

Fellow
Saint Louis University
Saint Louis Univeristy/Saint Louis, Missouri, United States

Coauthor(s)

DM

Dorothea Mostello, MD

Saint Louis University
Saint Louis Univeristy/Saint Louis, Missouri, United States

Objective:
We performed a multiphase quality improvement project that assessed the need for access to post-pregnancy care for patients with Type 2 Diabetes (T2DM) and implemented a protocol to facilitate scheduled postpartum diabetes follow-up. We also aimed to standardize postpartum hospital management of T2DM to support this transition of care.

Study Design:
In phase 1, we performed an anonymous survey of patients with T2DM on their experiences and perceptions regarding access to diabetes care outside of pregnancy. In phase 2, we established postpartum follow up for diabetes care antepartum by ascertaining whether the patient had a primary care provider (PCP) or endocrinologist, providing referrals as needed, and using a Smartphrase to document the status of the process. We also implemented a hospital-based protocol to standardize postpartum inpatient care for patients with T2DM by assessing need for intravenous insulin in the immediate postpartum period, monitoring glycemic control after delivery, and establishing a postpartum medication regimen.

Results:
Our survey of 32 patients found that over 90% of our patients understood the importance of managing diabetes outside of pregnancy, yet fewer than 60% followed with a PCP regularly prior to pregnancy. Approximately 25% did not have a PCP and identified cost as a serious barrier to their healthcare. From our Phase 2 intervention, we observed an improvement in documented PCP/Endocrinologist follow-up or referral from pre-intervention (N=28) of 53.6% to post-intervention (N=24) of 91.7% (p < 0.01). Additionally, we found improvement in both insulin use in the first 24 hours (21.4% vs 73.9%, p < 0.01) and prevention of metformin use in the first 24 hours (45.5% vs 8.7%, p < 0.05) postpartum.

Conclusion:
Our study established the need for improved postpartum follow-up of T2DM care and significantly improved our rates of scheduled follow-up or referral. Additionally, we implemented an inpatient postpartum protocol for management of T2DM, which improved medication dosing and timing.