The 5National Diabetes in Pregnancy Conference entitled ‘Challenges & Innovative Practice’ took place in London in November. More than 400 healthcare professionals attended the event, which was organised by the Diabetes UK Midlands Regional Office and sponsored by Novo Nordisk.
Diabetes UK Midlands Regional Head, Pete Shorrick, opened the conference with Dr Sarah Finer , welcoming the delegates. Chris Askew, Diabetes UK CEO followed this, and spoke about how the charity can supports HCPs’ work. He referencedinformation prescriptionsand the role they can play in empowering patients to manage their condition better. He also re-iterated how important it is forwomen to have all the information they need before they are pregnant.
He was followed by Jonathan Valabhji, National Clinical director for Obesity & Diabetes, NHS England. He spoke about the tough and challenging times facing the NHS, but re-iterated there were exciting times within this and referenced the Healthier You programme which is being rolled out and is targeting people at risk of developing Type 2 diabetes.
Prof Shakila Thangaratinam chaired the rest of the morning’s session which looked at preventing diabetes in pregnancy. Rebecca Reynolds, from University of Edinburgh, presented on the EMPOWaR trial: metformin in obese pregnant women; Hassan Shehata, from St George’s Medical School presented the MOP trial on the same subject and Lucilla Poston revealed findings from the UPBEAT trial: behavioural intervention in obese pregnant women.
It was shown that metformin had no effect on the birthweight of the baby. Speakers said there is a trend in obesity going up in pregnancy and that they are playing catch-up as overweight women are coming to them and they are already pregnant. It was also noted that obesity is linked to poor breastfeeding, more needed to be done to encourage obese mothers to breastfeed for longer.
It was also noted that control of gestational weight gain is very important, but stressed how difficult it is to prevent gestational diabetes in pregnant women.
Nick Lewis-Barnard, Northumbria Healthcare NHS Foundation Trust, presented findings from theNational Pregnancy in Diabetes Audit. It looked at improving the outcomes of pregnant women with pregestational diabetes. It was noted that few women are adequately prepared for pregnancy and that this was as much about women with Type 2 diabetes as women with Type 1 diabetes. He also told the delegates that there are large variations between services suggesting that there is lots of potential learning to share.
The afternoon session focused on technological advances for treating women with diabetes in pregnancy. Zoe Stewart, University of Cambridge, presented her study:Artificial pancreas in pregnant women with Type 1 diabetes. It concluded that at home overnight closed-loop appears safe and effective in pregnancy and that it may reduce hyperglycaemia without increasing hypoglycaemia and without increasing insulin dose. She concluded that adequately powered clinical outcome trials are warranted.
Eleanor Scott from University of Leeds presented oncontinuous glucose monitoring(CGM) in diabetes and revealed that while it is not known whether CGM can improve glucose control and pregnancy outcomes, it gives unprecedented insight as to why women with diabetes are still having big babies and shows that overnight glucose control is important and needs targeting.
The 6National Diabetes in Pregnancy Conference is planned to take place in November 2017 in Leeds.