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.
Units for reporting HbA1c have changed from % to mmol/mol since this guideline was published. The NICE Pathway on diabetes has been changed to reflect this. The guideline is being updated and the new version (to be published in 2015) will use mmol/mol.
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 220.127.116.11 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.