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Experts warn of high sugar level dangers in pregnancy

74% of pregnant women have potentially dangerously high blood glucose

Adrian O'Dowd

Wednesday, 18 November 2015

More support is needed for women with diabetes who become pregnant, as a new report has revealed three quarters of them have blood glucose levels in early pregnancy that can damage the health of their unborn child.

The National Pregnancy in Diabetes (NPID) Audit Report – 2014, published today, looked at 2,537 women with diabetes who were pregnant in 2014 in England, Wales and the Isle of Man.

It shows that 85% of women (815) with type 1 diabetes and 64% (491) with type 2 had higher than recommended blood glucose levels in early pregnancy, which increases risk of stillbirth, neonatal death and babies being born with congenital abnormalities.

The audit, managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK and supported by Public Health England (PHE), measures the implementation of national guidance on the care of women with diabetes who become pregnant.

It found that almost 12% (112) of women with type 1 diabetes and 8% (62) of women with type 2 diabetes had blood glucose levels above the level where women are advised to avoid pregnancy.

Just over half of women (601) with type 1 diabetes and only a third (355) of women with type 2 diabetes were taking folic acid supplements prior to becoming pregnant.

In addition, a tenth (112) of women with type 2 diabetes were taking medication when they became pregnant that can cause harm to the baby.

The authors of the audit analysed 2013 and 2014 data together because adverse outcomes are relatively rare.

They found that women whose baby was born with a congenital abnormality were more likely to have had high blood glucose levels in early pregnancy.

The audit’s lead clinician and advisory group chair, Dr Nick Lewis-Barned, said: “There are three key elements of pregnancy preparation for women with diabetes to reduce the risk of adverse pregnancy outcomes – good control of blood glucose levels, taking folic acid supplements and a medication review.

“It’s clear from the audit that many women need more information and more support in all of these areas.

“This means we need to work much more effectively on improving links between policy makers, commissioners, acute trusts, clinical teams, and local general practices and the community to ensure that women get the support they need to have healthy pregnancies.”

Chris Askew, chief executive of Diabetes UK, said: “It is deeply worrying that so many women with diabetes do not have their condition under control during the early stages of pregnancy, as this is putting the health of the baby at risk.

“The clear message of this report is that many women with diabetes are not getting the advice and support they need when it comes to planning to become pregnant and the stark fact is that in too many cases this is leading to tragic consequences such as death or disability of the baby with a third of babies born to mothers with diabetes needing intensive or specialist neonatal support.”

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