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Calling for better support for women with diabetes in pregnancy

pregnancy woman with nurse

Our analysis of the latest data looking at pregnancy in England, Wales and Isle of Man shows gaps in the support available to pregnant women living with diabetes both before and during pregnancy. This is leaving thousands of women at risk of serious complications.

Latest National Pregnancy in Diabetes audit results

The 2017/2018 National Pregnancy in Diabetes (NPID) audit showed that almost one in two babies of women with diabetes are large for their gestational age, and that admissions to neonatal units remain very high for babies of women with diabetes when compared to the general population.

The report showed that – despite progress to improve care in some areas – women with diabetes still have significantly poorer outcomes in pregnancy than the general population, and that hasn't changed since the audit began in 2013.

Between 2017 and 2018, while the vast majority of women with diabetes went through pregnancy safely and childbirth without serious complications, 170 out of 8,255 pregnancies recorded in the NPID resulted in stillbirth or neonatal death. This makes women with diabetes 3 to 4 times more likely to experience such serious complications when compared to the general population in England and Wales.

Women with diabetes 3 to 4 times more likely to have pregnancy complications 

While there are steps you can take to reduce the risk of complications, the audit also revealed that seven out of eight women with diabetes were still not achieving NICE-recommended risk-reducing pregnancy preparations.

We know that progress is being made to make pregnancy safer for women with diabetes. Earlier this year it was announced that continuous glucose monitors (CGM) would be made routinely available for all pregnant women living with type 1 diabetes in England by 2021. But in addition to healthcare professionals keeping pre-pregnancy support front of mind, further evidence-based interventions for women with type 2 diabetes are also needed in order to help this group manage their risk during pregnancy.

We’re also urging healthcare professionals to be aware of the differences in care women with different types of diabetes may need, as more women are now being diagnosed with type 2 earlier in life and healthcare professionals might not be discussing pre-pregnancy planning with this group.

With more than 50% of pregnant women with type 2 diabetes recorded in the audit being from non-white backgrounds, and over 60% living in some of the most deprived socio-economic areas, action is needed to support women from these groups.

Our policy manager Nikki Joule said:

“The audit highlights that women with diabetes – regardless of whether they live with type 1 or type 2 diabetes – are still at a far greater risk of serious pregnancy and childbirth complications. This needs to change, and clinicians can lead the way in turning the tide.

We’ve seen progress in this area – such as the decision to roll out continuous glucose monitoring devices for pregnant women in England with type 1 diabetes – which is a positive move. But service-wide interventions need to be made to reduce the number of devastating pregnancy complications for all women with diabetes.

We know that more women are developing type 2 at a younger age, so it’s also important that healthcare professionals raise the issue with this group – and the steps they can take to have the safest pregnancy possible – before they begin trying to conceive.”

How to reduce your risk of pregnancy complications

We’re calling for healthcare professionals to think about pre-conception planning, and to have discussions about risk reduction with all women with diabetes who are of child-bearing age as early as possible.

But together with your healthcare team, there are things you can do to reduce your risk of problems during pregnancy and childbirth. Take these steps before getting pregnant or as soon as you know you're pregnant:

  • Talk with your healthcare team about the recommended safe levels for HbA1c.
  • Ask your healthcare team about taking high dose folic acid.
  • Get advice about medication – you can't take some type 2 medications, as well as some medications for blood pressure and cholesterol, during pregnancy.

Making sure you have the support you need in order to be able to take day-to-day decisions around managing your diabetes outside of clinical appointments is also very important.

"When I first got pregnant, I heard from my nurse that I needed to stay within certain levels. But I couldn't remember what those levels were so just being able to go to the Diabetes UK website and be able to see it all in one place really easily has just been so helpful."

- Lucy, talking about her experiences of pregnancy and managing diabetes

More information and support

We've got lots more information about pregnancy and diabetes – including how to plan ahead, how to manage your diabetes during pregnancy and what to expect after the birth.

And our online support forum has a group specifically for discussions about pregnancy. You don't need to log in to get involved and it can be a great way to get tips and advice from other people with diabetes going through similar experiences to you.

If you'd prefer to speak to someone and ask us questions, call us on 0345 123 2399.

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