This site is intended for Healthcare Professionals only

Scenario: Diabetes & pregnancy

Team Training bookmark icon off

Scenario: Diabetes & pregnancy

Lauren asks if she can have a quiet word with the pharmacist, so Parveen takes her into the consultation room....

“My partner Matt and I have decided to try for a baby but I’m a bit worried about my diabetes,” says Lauren. “It’s well controlled, but is there anything I need to bear in mind at this moment in time?”

Answer

Having good glycaemic control puts Lauren in the best position possible to try for a baby, but she is still sensible to ask for advice. She should go for a full review of her diabetes as soon as possible, to discuss her blood glucose targets, glucose monitoring, insulin regimen, and renal and general health.

At her review, she is likely to be provided with blood ketone testing strips and a meter so she is able to test if she becomes hyperglycaemic or unwell, and referred for retinal assessment if she has not been seen in the previous six months.

Lauren will need to take a higher dose of folic acid (prescription-only 5mg compared to OTC 400mcg) during pre-conception and the first 12 weeks of pregnancy to reduce the risk of neural tube defects in her unborn baby. If and when she does fall pregnant, she needs to be aware that she will have to put extra effort into her diabetes management and attend more appointments with healthcare professionals than an otherwise healthy expectant mother.

The bigger picture

Of the 700,000 or so women who give birth in England and Wales each year, around 0.5 to 1 per cent have pre-existing diabetes and require additional care due to the risks posed by the disease to both the mother and the unborn child, which include worsening diabetic retinopathy and a higher rate of miscarriage, pre-eclampsia, stillbirth, preterm labour, birth injury, perinatal mortality and congenital malformations. Gestational diabetes – diabetes that develops during pregnancy – affects over 4 per cent of women and is associated with the same risks.

Extend your learning

 

Question

What plasma glucose level indicates that a pregnant woman has gestational diabetes?

Answer

A fasting glucose level of 5.6mmol/L or higher, or a two-hour plasma glucose level of 7.8mmol/L or above are considered diagnostic of gestational diabetes according to the latest NICE guidance

 

Copy Link copy link button

Team Training

Team training helps you focus on how your team works together, enables you to improve professional relationships and build a stronger team.

Share: