by Colin Kenny, GP, Dromore
The new NICE guideline on diabetes in pregnancy (NG3) adopts emerging evidence on diabetes care in pregnancy. In particular, there are new recommendations in areas including diagnosing and treating gestational diabetes, using newer technologies for monitoring blood glucose and ketones, blood glucose targets before and during pregnancy, and diagnosing continuing glucose intolerance in women after the birth.
Primary care health professionals will want to consider modifying their practice on managing previous gestational diabetes, with its potential need for an oral glucose tolerance test. In addition, practices should have explicit guidance for women with diabetes planning pregnancy, as well as medicine management and the requirements of glucose self-monitoring and testing for ketonuria in pregnancy. The guidance suggests that antenatal care should be done in specialist units where possible, and that postpartum medicines management also needs careful consideration.
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