The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Changes to the National Diabetes Services Scheme (NDSS) now allow more people to access the Continuous Glucose Monitoring (CGM) products available under the scheme for free.
A new online course to support pharmacists in caring for people living with diabetes has also been launched by the Pharmaceutical Society of Australia (PSA) and Diabetes Qualified (DQ), the training arm of Diabetes NSW & ACT.
NDSS updates
Over 37,000 Australians can now access CGM products. Federal Minister for Health Greg Hunt MP announced that the Government would invest more than $100 million into the expansion of the Continuous Glucose Monitoring (CGM) Initiative.
The following demographics are now able to obtain subsidised CGM products:
- children and young people with conditions very similar to type 1 diabetes who require insulin;
- women with type 1 diabetes who are actively planning pregnancy, pregnant or immediately post-pregnancy; and
- people with type 1 diabetes aged 21 years or older who have concessional status, and have a high clinical need to access CGM products.
The Department of Health stressed the importance of applying the scheme in accordance with the specified eligibility to ensure that those most in need can be catered to. The Government has called for health professionals to take the necessary steps to ensure they are well-versed in the eligibility criteria before approving patient assessment forms.
There are a range of CGM products available under the scheme. The appropriate products should be selected through a consultation process by a qualified healthcare professional and the eligible patient. The Therapeutic Goods Administration approved products available under the scheme have varying indicated uses, so healthcare professionals will need to assess these before making a recommendation to each patient.
Patients can obtain the required CGM products free of charge from their local NDSS Access Point where they collect other NDSS products, such as blood glucose test strips. There are over 5,000 NDSS Access Points across Australia, mostly community pharmacies.
Community pharmacies and other health professionals that will be impacted should have received a notification from the Department of Health about the updates to the CGM Initiative.
For further information about the CGM Initiative, access the NDSS website, where you will find the eligibility criteria for each cohort and a list of available products. You can access the necessary application forms to register for the scheme along with instructions about the applications process. You can also access information about the scheme by calling the NDSS Helpline on 1300 136 588.
Diabetes training course
The Diabetes in Practice for Pharmacists course aims to help improve pharmacists’ health literacy to better support people living with diabetes to make informed choices about their health and thus improve health outcomes.
Diabetes in Practice for Pharmacists also supports several of the national priority actions in the recently released National Diabetes Implementation Strategy, contributing to the strategy’s goal of prioritising Australia’s response to diabetes and its complications and comorbidities, and reducing the impact of diabetes in the community.
knowledge in everyday practice and supporting patients through better engagement, asking more meaningful questions and giving advice or referring on as needed.
‘This new training program supports some of the key actions in PSA’s Pharmacists in 2023 by helping pharmacists in all practice settings have more supportive and meaningful conversations with their patients to prevent medicine misadventure and create better health outcomes,’ Dr Freeman said.
‘Diabetes is explained in simple terms using case studies and real life scenarios to provide examples of appropriate language to answer questions from a person living with diabetes about diabetes management and related products.’
The course includes interactive modules and is relevant for pharmacists, intern pharmacists and pharmacy students with a special interest in diabetes. The introductory module is free for PSA members and the course provides pharmacists with the flexibility to work at their own pace.
To access individual modules or the full course, please visit the PSA website or DQ website.
The PSA and Australian Diabetes Educators Association (ADEA) co-developed Pharmacist Diabetes Educator career pathway also supports pharmacists providing services to people living with diabetes.
