6b6d044e_s_in_pregnancy___NICE_Pathways__nulliparous_women_at_31_weeks_
[Appointment] Booking appointment (joint diabetes and antenatal care) – ideally by 10 weeks
Discuss information, education and advice about how diabetes will affect the pregnancy, birth and early parenting (such as breastfeeding and initial care of the baby). If the woman has been attending for preconception care and advice, continue to provide information, education and advice in relation to achieving optimal blood glucose control (including dietary advice). If the woman has not attended for preconception care and advice, give information, education and advice for the first time, take a clinical history to establish the extent of diabetes-related complications (including neuropathy and vascular disease), and review medicines for diabetes and its complications. Offer retinal assessment for women with pre-existing diabetes unless the woman has been assessed in the last 3 months. Offer renal assessment for women with pre-existing diabetes if this has not been performed in the last 3 months. Arrange contact with the joint diabetes and antenatal clinic every 1–2 weeks throughout pregnancy for all women with diabetes. Measure HbA1c levels for women with pre-existing diabetes to determine the level of risk for the pregnancy. Offer self-monitoring of blood glucose or a 75 g 2-hour OGTT as soon as possible for women with a history of gestational diabetes who book in the first trimester. Confirm viability of pregnancy and gestational age at 7–9 weeks.
Diabetes in pregnancy - NICE Pathways
Care for women with diabetes during pregnancyWomen with diabetes should also receive routine care according to the schedule of appointments in the NICE pathway on antenatal care, including appointments at 25 weeks (for nulliparous women) and 34 weeks, but with the exception of the appointment for nulliparous women at 31 weeks.