Diabetes NICE

Question 1

US monitoring of fetal growth in DM?

Answer 1

4 weekly from 28-36 weeks

Question 2

Who is offered retinal screening and when?

Answer 2

16-20 weeks if known diabetic retinopathy

28 weeks if pre-existing diabetes

Question 3

When to offer IoL in type 1/2 diabetes?

Answer 3

37 -39 weeks

Question 4

When to offer IoL if uncomplicated gestational diabetes?

Answer 4

Advise to give birth no later than 40+6

Question 5

How to monitor BMs in labour?

Answer 5

BM hourly
aim for 4-7mmol/L

Question 6

Who should you consider a sliding scale for in labour?

Answer 6

Type 1 diabetics
Unable to maintain BMs between 4-7 mmol/L

Question 7

Monitoring of baby post-natally?

Answer 7

Test blood glucose at 2-4 hours after birth.

Keep in hospital for 24 hours post-natally - ensure maintaining BMs and feeding well.

Question 8

How to manage IDDM after birth?

Answer 8

REDUCE insulin immediately after birth as risk of hypoglycaemia, especially if breast feeding

Question 9

Follow up for women with GDM after delivery?

Answer 9

Fasting glucose 6-13 weeks after delivery.
<6.0mmol/L = normal
6-7mmol/L = high risk for T2DM
>7mmol/L = T2DM likely and need confirmatory testing

> 13 weeks can do fasting glucose or HbA1c
<39 - normal
39-47 - prediabetic
48+ - T2DM

If negative - offer annual HbA1c testing