New NICE guidelines ‘could miss’ gestational diabetes diagnosis
Women at risk of gestational diabetes could be overlooked because of new healthcare guidelines, according to a new study.
Researchers at the University of Cambridge and Cambridge University Hospitals Foundation Trust believe the newly introduced gestational diabetes guidelines, set by the National Institute for Health and Care Excellence (NICE), could miss vital information needed for a diagnosis.
Dr Meek from the Wellcome Trust-MRC Institute of Metabolic Science at the University of Cambridge said there is a “fundamental difference” between the new criteria and the guidelines laid out by the World Health Organization (WHO) when it comes to identifying women who could be at risk.
He 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.”
In February the NICE guidelines introduced the guidelines which recommended using a less strict fasting blood sugar threshold for the diagnosis.
But the research, which was carried out on 25,000 women who gave birth in Cambridge between 2004 and 2008, found that those who had borderline levels of fasting blood sugar were at a much higher risk of having a heavier baby.
They were also twice as likely to have an emergency Caesarean section and seven times more likely to develop excessive amniotic fluid. All those women would have been missed under the NICE criteria.
Using the WHO guidelines, which required one test to be taken in the fasting state and a further two other tests taken one and two hours after a drink containing sugar, would have resulted in 126 more diagnoses of gestational diabetes over five years.
Dr David Simmons, from Cambridge University Hospitals, said: “Doctors need to be aware that the new NICE criteria will miss high-risk women, especially those with borderline fasting blood sugar.”