Pregnant women with diabetes face unacceptable standards of care

Jack Woodfield
Fri, 13 Oct 2017
Pregnant women with diabetes face unacceptable standards of care
Pregnant women with diabetes face "unnecessary difficulties" when it comes to the standard of care they are provided with in England and Wales.

The National Pregnancy in Diabetes Audit 2016 looked at how well cared for expectant mothers are with diabetes. The report showed 42 per cent of women with type 2 diabetes and 24 per cent with type 1 diabetes were not seen in specialist clinics before they reached 10 weeks.

This is despite recommendations from the National Institute for Care and Excellence (NICE) which states a joint diabetes and antenatal appointment should be provided for pregnant women with diabetes as soon as they find out they are carrying a baby.

Having diabetes during pregnancy can increase the risk of miscarriage, preterm delivery, pre-eclampsia and other complications. Those health issues can be radically reduced if the diabetes is managed well during pregnancy. An appointment at or near the start of pregnancy can help to get diabetes under control at an earlier stage and therefore reduce the risk of problems developing.

The audit showed neonatal deaths and stillbirth rates are more prevalent in women with diabetes when compared to those who do not have the condition and the figures also showed nearly one in two babies suffered from complications which was related to their mothers’ diabetes.

Caesarean sections were common with 64.7 per cent occurring in pregnant women with type 1 diabetes and 56.9 per cent of those with type 2 diabetes.

A total of 3,356 pregnancies in 3,297 women were looked at as part of the report, which was conducted by NHS Digital and support by Diabetes UK.

Figures suggested nearly one in 10 women with type 1 diabetes were admitted to hospital with severe hypoglycemia at least once during their pregnancy and 2.7 per cent of those with type 1 diabetes suffered from diabetic ketoacidosis.

The audit authors have issued a series of recommendations which include increasing awareness among all women with diabetes of the risks and actions to take before they get pregnant and improving access to specialist support in early pregnancy.
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