Recommendation for NHSScotland
Continuous glucose monitoring (CGM) should be offered to all pregnant women with type 1 diabetes (T1DM). The case for adopting CGM in pregnant women with T1DM is supported by the clinical evidence.
The use of CGM during pregnancy may improve maternal glycaemic control compared with self-monitoring of blood glucose (SMBG). CGM reduces neonatal hypoglycaemia and the need for and duration of neonatal intensive care. These improved clinical outcomes were reported in women who used CGM from the first trimester of pregnancy.
Cost modelling estimates that the use of CGM in mothers with T1DM is cost saving compared with SMBG, with cost savings largely driven by a reduction in neonatal intensive care requirements.
A prospective dataset should record all pregnant women with T1DM in NHSScotland, capturing clinical outcomes for mother and child, and the technology used to measure blood glucose levels.
The Scottish Health Technology Group (SHTG) recommendation is based on guidance produced by Health Technology Wales (HTW) in 2019. The original HTW guidance was modified following an SHTG adaptation process.
NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.
What were we asked to look at?
We were asked to review the evidence surrounding the use of CGM in pregnant women with T1DM, and provide recommendations for NHSScotland.
Why is this important?
There is existing Scottish Government policy support for the use of CGM in diabetes including an announcement in 2017 of funding to encourage the implementation of CGM. SHTG advice is required to inform adoption, particularly for pregnant women with T1DM who are considered amongst the highest priority for the technology.
The Scottish Diabetes Group (SDG)