The National Institute for Health and Care Excellence (NICE) has agreed to review its diabetes in pregnancy guidelines focusing on continuous glucose monitoring (CGM) for pregnant women with type 1 diabetes in England.
NICE, a public body which advises on the use of new medicines and technology on the NHS, made the decision after considering new evidence, which showed improvements in a range of neonatal outcomes when continuous glucose monitoring is used in addition to standard care.
NICE covers England. Its equivalents in Wales and Northern Ireland often adopt its guidance. Scotland has a more separate system.
In September 2017, JDRF-funded researchers announced that pregnant women living with type 1 diabetes, who used a continuous glucose monitor throughout their pregnancy in the trial, named CONCEPTT, had better blood glucose control and healthier babies.
Evidence from the trial, submitted to NICE by JDRF and INPUT, also found that improved outcomes for expecting women were accompanied by substantial reductions in newborn complications.
NICE is also planning a partial update to the use of CGM before conception, based on findings from the CONCEPTT trial that women are less comfortable changing the mode of monitoring their glucose levels during early pregnancy and that initiating the use of a CGM prior to becoming pregnant would therefore be of benefit.
The recommendations were supported by a number of organisations including The Royal College of Obstetricians and Gynaecologists (RCOG), Association of British Clinical Diabetologists, Diabetes UK and King’s College Hospital NHS Foundation Trust, who along with JDRF with INPUT, all referenced the CONCEPTT trial in their submissions.
NICE will now conduct a full systematic evidence review in which recommendations will be made for the changes, before going to a full consultation with stakeholders – of whom JDRF is one.