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69 NMH Annual Rep t | 2020 Kayleigh O'Sullivan with her newborn baby daughter Millie Rita McAnaspie. Maternity and Obstetrics being made in diabetes care internationally. Current figures show that over 50% of women with T1DM in our service are now using insulin pumps. Although the numbers of women with pre-existing diabetes in the service are small compared to the GDM cohort they are under the care of the service from six weeks' gestation and require weekly MDT input. One of the biggest changes of 2020 was to screening for GDM, following the advice from both the Royal College of Obstetricians and Gynecologists and the Institute of Obstetricians. We have a long practice of risk based screening using a two-step approach (GCT, then OGTT if positive GCT) but the waiting time for OGTT was not feasible to allow for social distancing. Similar to 70% of units within the UK we changed to testing using HbA1c/fasting glucose to screen for GDM. An audit of this practice showed a reduction in the rate of GDM diagnosis and in July of 2020 we returned to usual practice. A full and detailed research study analyzing the long-term outcomes for mother and baby of this temporary approach is being completed for publication. With the onset of COVID-19, the hospital's diabetes in pregnancy service introduced a change in clinical practice for women diagnosed with gestational diabetes mellitus (GDM) as women were traditionally brought into a midwifery led clinic for education, venous blood sampling and self-monitoring of blood glucose review. The diabetes midwifery service has now been entirely transformed into a virtual telehealth service from the point of diagnosis, treatment and through to discharge. From diagnosis, women are educated on a live webinar with midwives and dietitians, and then followed up with a Q&A webinar and virtual telehealth clinic. The team sourced a blood glucose monitor, which is Bluetooth enabled and syncs to an App that auto-populates to a patient master list. It also allows for escalation to the Registered Advanced Midwife Practitioner for review if pharmacological treatment is needed. From there women can be referred to Endocrinology and Obstetrics within the Diabetes and Pregnancy specialist clinic if required. With the twinning of the "Attend Anywhere" virtual consultation platform and the new remote glucose monitoring, the team aim to deliver evidence-based care on a more personal level to transform the service for women. A patient survey reveals that the education webinars are meeting the needs of women with GDM in our service. Administrative support from Helen McCrimmon has been essential in implementing telehealth for midwifery and dietetics. Year Type 1 diabetes Type 2 diabetes GDM and Previous GDMs Impaired glucose tolerance Cystic Fibrosis Related Diabetes Maturity Onset Diabetes of the Young (MODY) Total 2015 44 14 382 213 - - 653 2016 42 17 365 248 - - 672 2017 46 24 302 223 - - 595 2018 40 13 354 251 - - 658 2019 39 20 364 231 - - 654 2020 43 19 589 N/A* 3 2 656 *Impaired Glucose Tolerance had previous been defined as on raised value on an Oral Glucose Tolerance Testing (OGTT). From March 2020 (COVID-19 Planning) Gestational Diabetes defined as any form of glucose intolerance on OGTT.