Individual research recommendation details

Recommendation ID

NG3/1

Question

What are the roles of insulin pump therapy (continuous subcutaneous insulin infusion) and
continuous glucose monitoring in helping women with diabetes to achieve blood glucose targets
before pregnancy?

Any explanatory notes
(if applicable)

Babies born to women with diabetes have a high risk of having congenital malformations and this
risk is greater if blood glucose control is poor around the time of conception. However, lowering the
risk to that of women without diabetes would require normalisation of blood glucose levels, and
this is difficult to achieve without increasing the risk of serious hypoglycaemia. Insulin pump
therapy and continuous glucose monitoring have been shown to reduce both blood glucose levels
and rates of hypoglycaemia in the non-pregnant population, but it is uncertain if this holds true
before conception and in early pregnancy. There is therefore an urgent need to test the
effectiveness and acceptability of these technologies in women with diabetes who are planning
pregnancy. This would be best undertaken in a randomised controlled trial of women with diabetes
who are trying to conceive. Women would be allocated to receive either conventional care
(self-monitoring of blood glucose and insulin adjustment) or insulin pump therapy and continuous
glucose monitoring.

Source guidance details

Comes from guidance

Diabetes in pregnancy: management from preconception to the postnatal period

Number

NG3

Date issued

February 2015

Other details