Management of diabetes in pregnancy (original) (raw)

Current status

This guideline was published in 2024 and replaces the corresponding section in SIGN 116: Management of diabetes. It will be considered for review in three years. The review history, and any updates to the guideline in the interim period, are noted in the update report.

Summary

In Scotland, around 1 in 175 pregnancies is complicated by pre-existing diabetes, of which around 70% are type 1 diabetes mellitus (T1DM) and 30% are type 2 diabetes mellitus (T2DM). Up to 11% of pregnancies may be complicated by incident GDM and early screening may detect up to 3% of women with likely undiagnosed diabetes in early pregnancy.

The guideline provides recommendations on

• preconception care in women with known pre-existing diabetes,
• antenatal care for all women with diabetes in pregnancy,
• risk factors, diagnosis and treatment of GDM, and
• detecting glucose intolerance after pregnancy.

Other than in the specific context of management of women with GDM, prevention or remission of type 2 diabetes is not included in the remit of this guideline. These, and further issues are covered by SIGN 172: Prevention, early recognition and treatment, and remission of type 2 diabetes.

Who it's for

This guideline will be of interest to healthcare professionals in primary and secondary care involved in the care of women with diabetes and their newborn babies, including:

• general practitioners (GPs),
• nurses and midwives,
• obstetricians,
• diabetes physicians,
• neonatal paediatricians,
• dietitians, and
• pharmacists.

It will also be of interest to women with pre-existing diabetes, those who develop diabetes during pregnancy and their families. We will also be producing a booklet for patients, families and carers.

How this guideline was developed

This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.

SIGN 171, May 2024