Improving gestational diabetes care: A clinical audit on the consistency of self-monitoring of blood glucose in the Antenatal Clinic at District General Hospital, Kilinochchi

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with adverse maternal and fetal outcomes. Self-monitoring of blood glucose (SMBG) is essential in achieving glycaemic control and guiding timely escalation of treatment. However, the consistency of SMBG and documentation may be suboptimal due to financial constraints, limited access to glucometer strips, and gaps in follow-up practices.Aim: To assess the consistency of SMBG among pregnant women diagnosed with GDM attending the antenatal clinic at District General Hospital, Kilinochchi.Methods: A descriptive clinical audit was conducted at the antenatal clinic from 10/09/2025 to 10/02/2026. All pregnant women diagnosed with GDM between 20 and 37 weeks of gestation and followed up during the audit period were included. Data were collected from clinic notes, blood sugar surveillance (BSS) registers, and patient-held glucose monitoring records using a structured data collection form. The audit standard was set at ≥90% of women with GDM having documented evidence of regular blood glucose monitoring (BSS and/or home SMBG) at each follow-up visit.Results: A total of 204 women with GDM were reviewed. Monitoring was performed using BSS only in 43 (21%), home SMBG only in 33 (16%), and both methods in 128 (63%). Consistent monitoring with documentation was observed in 94 women (46%), while 75 (37%) demonstrated inconsistent monitoring and 35 (17%) had no documented monitoring. Documentation was available in clinic notes for 133 women (65%), patient-held records only for 57 (28%), and absent in 14 (7%). The audit standard of ≥90% was not achieved.Conclusion: SMBG consistency and documentation among women with GDM attending this clinic were suboptimal. Strengthening patient education, introducing standardized monitoring charts, ensuring review and documentation at every visit, and improving access to testing supplies are recommended. A re-audit is proposed after 6–12 months following implementation of interventions.