Female—type of diabetes mellitus during pregnancy, code N

Identifying and definitional attributes

• Health, Standard 09/09/2022

Data element concept attributes

Identifying and definitional attributes

• Health, Standard 07/03/2014

Value domain attributes

Identifying and definitional attributes

• Health, Standard 03/12/2020

Representational attributes

Collection and usage attributes

Note that where there is a Gestational diabetes mellitus (GDM) and a current history of Pre-existing Type 2 diabetes then record Code 2 Pre-existing Type 2 diabetes.

While most women will know what type of diabetes they have, where their type of diabetes is unknown the clinician should leave the collection form/system blank. This will be coded as a '9' by the data custodian.

CODE 1   Pre-existing Type 1 diabetes

Beta-cell destruction, usually leading to absolute insulin deficiency. Includes those cases attributed to an autoimmune process, as well as those with beta-cell destruction and who are prone to ketoacidosis for which neither an aetiology nor pathogenesis is known (idiopathic). It does not include those forms of beta-cell destruction or failure to which specific causes can be assigned (e.g. cystic fibrosis, mitochondrial defects). Some subjects with Type 1 diabetes can be identified at earlier clinical stages than 'diabetes mellitus'.

CODE 2   Pre-existing Type 2 diabetes

Type 2 includes the common major form of diabetes, which results from defect(s) in insulin secretion, almost always with a major contribution from insulin resistance.

CODE 3   Gestational diabetes mellitus (GDM)

GDM is a carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or first recognition during pregnancy. The definition applies irrespective of whether or not insulin is used for treatment or if the condition persists after pregnancy.

Diagnosis is to be based on the Australasian Diabetes in Pregnancy Society (ADIPS) Guidelines (Nankervis et al. 2014). If the clinician does not have information as to whether these guidelines have been used, available information about diagnosis of GDM is still to be reported.

CODE 8   Other type of diabetes mellitus

This categorisation include less common causes of diabetes mellitus, but are those in which the underlying defect or disease process can be identified in a relatively specific manner. They include, for example, genetic defects of beta-cell function, genetic defects in insulin action, diseases of the exocrine pancreas, endocrinopathies, drug or chemical-induced, infections, uncommon forms of immune-mediated diabetes, other genetic syndromes sometimes associated with diabetes. Impaired glucose regulation is not to be included here.

CODE 9   Not stated/inadequately described

To be recorded by data entry personnel (state/territory health authority) if the data field is left blank or is inadequately completed in the perinatal data collection form or extract. Clinicians should not record Code 9.

Source and reference attributes

Nankervis A, McIntyre HD, Moses R, Ross GP, Callaway L, Porter C et al. 2014. Australasian Diabetes In Pregnancy Society (ADIPS) Consensus Guidelines for the Testing and Diagnosis of Hyperglycaemia in pregnancy in Australia and New Zealand. Sydney: ADIPS. Viewed 18 September 2020,http://www.adips.org/downloads/2014ADIPSGDMGuidelinesV18.11.2014_000.pdf

Data element attributes

Collection and usage attributes

The diagnosis is preferably derived from, and substantiated by, clinical documentation which should be reviewed at the time of delivery. However, this information may not be available, in which case the patient may self-report to the clinician that they have been diagnosed with a particular type of diabetes mellitus.

Jurisdictions that record perinatal data using the ICD-10-AM should apply the following codes:

'Code 1 Pre-existing Type 1 diabetes' is equivalent to O24.0 in the ICD-10-AM.

'Code 2 Pre-existing Type 2 diabetes' is equivalent to O24.12-O24.19 in the ICD-10-AM.

'Code 3 Gestational diabetes mellitus (GDM)' is equivalent to O24.42-O24.49 in the ICD-10-AM.

'Code 8 Other type of diabetes mellitus' is equivalent to O24.22-O24.29 in the ICD-10-AM. O24.32-O24.39 in the ICD-10-AM may also be coded to 8 in the absence of any further information on type of diabetes.

Note that there is no equivalent permissible value for O24.92-O24.99 in the ICD-10-AM. In the absence of any further information on type of diabetes, these should be coded as ‘Code 9 Not stated/inadequately described’.

See also related data element Female—type of diabetes mellitus therapy during pregnancy, code N where the following ICD-10-AM fifth character subdivisions are for use with categories O24.1–O24.9 to record therapy type:

• 2  Insulin treated
• 3  Oral hypoglycaemic therapy
• 4  Other: diet, exercise, lifestyle management
• 9  Unspecified.

Source and reference attributes

Independent Hospital Pricing Authority 2022. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), Twelfth Edition. Tabular List and Alphabetic Index. Darlinghurst, NSW.

Relational attributes