Did you know?

What is the California Diabetes and Pregnancy Program?

What is Sweet Success?

More about the Guidelines

Some not so SWEET facts

Some SWEET facts

What you can do

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Did you know?

• Diabetes is a major cause of morbidity during and after pregnancy for both mom and baby,

• Hyperglycemia is a major teratogen,

• Hispanic, Native American, African American, East Indian and Asian women have a higher risk of type 2 diabetes mellitus and may enter pregnancy already hyperglycemic,

• Early screening (at first prenatal visit) will help identify your hyperglycemic patients

What is California Diabetes and Pregnancy Program?

The mission of the California Diabetes and Pregnancy Program (CDAPP) is to improve pregnancy outcomes for women who have preexisting or gestational diabetes by using a multidisciplinary team approach, evidence-based and culturally appropriate strategies for care, as outlined by the “Sweet Success Guidelines for Care 2002”.

California is divided into perinatal regions, each with a regional Diabetes and Pregnancy Team that provides training and consultation to clinical staff who utilize the “Sweet Success Guidelines”.

The Regional California Diabetes and Pregnancy Team consists of a multidisciplinary group of consultants, including a nurse educator, a physician, a registered dietitian, and a behavior medicine specialist who are are available in each perinatal region to educate, consult with, and mentor new and existing Sweet Success Clinical Affiliates.The CDAPP teams are working to ensure quality diabetes and pregnancy services and to improve access to preconception, pregnancy, and postpartum education to all providers and women of childbearing age.

What is Sweet Success?

Sweet Success refers to diabetes and pregnancy self-management programs within provider sites throughout California. It is an educational, clinical program that offers multidisciplinary team services during preconception, pregnancy and post-partum. This program was designed by the California Diabetes and Pregnancy Program (CDAPP) of the Maternal and Child Branch of the Department of Health Services.

More about the Guidelines

The “Sweet Success Guidelines for Care” are patient management references for multidiscipline providers, including clinical care. “The Guidelines” strive to be evidence based, scientifically supported, and contain up to date standards of care. They are periodically revised by a consensus of recognized experts in the field, who are experienced in setting standards for the care of women experiencing diabetes during pregnancy at various clinical settings throughout the State of California.

Some not so SWEET facts

Uncontrolled pregestational diabetes is a major cause of birth defects. Using the “Sweet Success Guidelines” for preconception care can reduce the risk of malformations to that of the non-diabetic population. Kitzmiller JL, Combs CA, Buchanan TA, Ratner RE, Kjos S. Preconception care of diabetes: Congenital malformations and spontaneous abortions. Diabetes Care 1996; 19(5): 514-41.

Diabetes in pregnancy means much more than a large for gestation baby.
We now have evidence that the uncontrolled diabetic intrauterine environment has long term effects, such as obesity, hypertension, and early onset of type 2 diabetes on the offspring. Silverman BL, Rizzo TA, Cho NH, Metzger BE. Long term effects of the intrauterine environment. Diabetes Care 1998 (suppl 2); 21: B142-49.Rosenbloom AL, Joe JR, Young RS, Winter WE. Emerging epidemic of type 2 diabetes in youth. Diabetes Care 1999; 22(2): 345-54.

Some SWEET facts

There is a way to address the type 2 diabetes epidemic. Although there are
800,000 new cases every year in the United States, providers of women’s health care can help reduce this number. With the knowledge that a family history of diabetes, personal history of gestational diabetes or large for gestational age (LGA) baby, ethnicity including Hispanic, Asian, Native American, African American, East Indian and indigenous Australian places a woman at high risk for already having diabetes, providers can screen for diabetes at the first prenatal visit. Early identification of women with diabetes and subsequent education stressing lifestyle changes (diet and exercise) can prevent or delay the onset of this deadly disease. Sweet Success programs are designed to tackle this challenge. Peters RK, Kjos SL, Xiang A, Buchanan TA, Long term diabetogenic effect of single pregnancy in women with previous gestational diabetes mellitus. Lancet 1996; 347: 227-30.
Hilary King, MD, DSC. Gestational Diabetes Mellitus Epidemiology of Glucose Intolerance and Gestational Diabetes in Women of Childbearing Age. Diabetes Care Volume 21 Supplement 2 Proceedings of the Fourth International Workshop-Conference on Diabetes in Pregnancy., 1999,

Studies have shown that $3.00 to $5.00 are saved for every $1.00 spent on
diabetes and pregnancy care. Caring for women who have diabetes is much more costly than the costs associated with the Sweet Success Program - even if only 1 in 10 women makes life style changes.
York R, Brown LP. Women with diabetes during pregnancy: Sociodemographics, outcomes, and costs of care. Public Health Nursing; 12(5): 290-3; Oct 1995.
Kitzmiller JL. Cost Analysis of Diagnosis and Treatment of Gestational Diabetes Mellitus. Clin Obstet Gyn 2000; 43(1): 140-53.
GregoryKD, Kjos SL, Peters RK. Cost of non-insulin-dependent diabetes in women with a history of gestational diabetes: Implications for prevention. Obstet Gyn 1993; 81(5): 782-6.

What you can do

If you are not already a part of the California Diabetes and Pregnancy Program’s Sweet Success, now is the time to become a part of this diabetes and pregnancy network and provide your patients with the best chance at prevention. Here’s how to get involved:

Refer your patients to trained Sweet Success Affiliates

Call your nearest regional program for more information

For more information contact: San Diego and Imperial Counties CDAPP at 858 536-5090 or send us an email