Pregnancy diabetes guidelines risks lives of thousands of mothers and babies
Researchers at Cambridge University have raised concerns that over 4,000 pregnant women in the UK could be left undiagnosed with gestational diabetes; with the UK thresholds for investigation being much higher than those recommended by the World Health Organisation (“WHO”).
Despite recent lowering of the UK’s threshold for referral, current guidelines only recommend referral for diagnosis when a patient presents a fasting blood sugar reading of 5.6mmol per litre or more. The WHO guidelines recommend referral when a level of 5.1mmol per litre is identified.
Dr Claire Meek, the scientist behind the research, said “The international criteria are based on minimising the risk of harm to the mother and baby, whereas the NICE criteria have been based upon reducing costs to the NHS”.
The effect of gestational diabetes is potentially life threatening, and can lead to birth defects, overweight babies and even miscarriage. Research also suggests that women with undiagnosed gestational diabetes are twice as likely to require an emergency C-section; which has its own complications. All of these risks could lead to a heavily disabled child, injured in utero or during birth, or parents grieving for their unborn child.
Professor Mark Baker, Director of Clinical Practice at NICE, the organisation that sets clinical guidelines in the UK, has said that the WHO have themselves acknowledged their guidance on gestational diabetes needs to be revisited; they do not provide enough benefit to offset the high cost of implementing its guidelines. Whilst this statement actually supports Dr Meek’s view that the NICE guidelines are all about costs, Dr Baker added “we welcome new research … and will keep the guideline under surveillance”.