Diabetes in pregnancy

Summary

This guidance covers the care and treatment of pregnant women with diabetes in the NHS in England and Wales. It also covers the care of their newborn babies. It is written for women who have diabetes or develop it in pregnancy, but it may also be useful for their families or for anyone with an interest in the condition.

July 2008: Since publication, the information on the therapeutic indications, contraindications and use in pregnancy and lactation of drugs used in diabetes management and retinal assessment (specifically insulins, the oral hypoglycaemic agents metformin and glibenclamide, and tropicamide) has been corrected to follow the relevant summaries of product characteristics (SPCs) (July 2008). Changes have been made to the NICE guideline, the full guideline and the quick reference guide.

'The recommendation on the use of the rapid-acting insulin analogues aspart and lispro in pregnant women with diabetes (this is recommendation 1.1.6.2 in the NICE guideline) is now as follows:

Healthcare professionals should be aware that data from clinical trials and other sources do not suggest that the rapid-acting insulin analogues (aspart and lispro) adversely affect the pregnancy or the health of the fetus or newborn baby.

The electronic versions of the guideline on this website all contain the correct information on drugs used in diabetes management and retinal assessment. Hard copies of the corrected quick reference guide are being mailed to the NHS.

The Understanding NICE guidance booklet does not give all details of the information healthcare professionals need to consider when prescribing insulin and other drugs used to manage diabetes or for retinal assessment in women who are pregnant or breastfeeding. Therefore it did not require any changes to reflect the reissued guideline on diabetes in pregnancy and has not been reissued.

Documents

For healthcare professionals

• CG63 Diabetes in pregnancy: NICE guideline (reissued July 2008)
• CG63 Diabetes in pregnancy: NICE guideline (reissued July 2008) (MS Word format)
• CG63 Diabetes in pregnancy: full guideline (reissued July 2008)
• CG63 Diabetes in pregnancy: full guideline - search strategies
• CG63 Diabetes in pregnancy: full guideline - evidence tables
• CG63 Diabetes in pregnancy: quick reference guide (reissued July 2008)

For patients, carers and the public

• CG63 Diabetes in pregnancy: understanding NICE guidance
• CG63 Diabetes in pregnancy: understanding NICE guidance (MS Word format)
• CG63: Diabetes yn ystod beichiogrwydd: deall canllawiau NICE (fformat MS Word)

Background information

• 2008/021 NICE guideline will help women with diabetes plan for a healthy pregnancy and baby

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• Diabetes in pregnancy: costing template
• Diabetes in pregnancy: costing report
• Diabetes in pregnancy: slide set
• Diabetes in pregnancy: audit support