Tayside Diabetes MCN Handbook
Protocol for Management of Patients with Type 1 and Type 2 Diabetes attending Infertility and Assisted Conception Clinic

Patient referred by GP or other sources seen in the General Infertility Clinic

  • Routine investigations as indicated
  • Letter to GP
  • Letter to appropriate Diabetes Physician (Dr Connacher for PRI, Dr Brennan / Dr Leese/ other for Angus & Ninewells) indicating patient attending infertility clinic and request review appointment for pre pregnancy counselling and stabilising of HbA1C (patient consent to be taken). Patient will be seen urgently by the Diabetic Team
  • Reiterate pre pregnancy advice (SIGN 116) including 5mg Folic Acid tablets
  • Newly diagnosed diabetes (in the Infertility clinic) to be referred to the appropriate Diabetes Physician (Ninewells, Angus or PRI)

Review appointment

  • Ensure has seen Diabetes Physician and correspondence from the team indicates that reasonable diabetic control has been achieved. This may also include control of Hypertension and BMI
  • Plan and Commence treatment when appropriate.
  • Check whether taking Folic Acid tablets
  • Inform Diabetes Physician with copy to appropriate Diabetes Specialist Nurse (Ninewells, Angus or PRI) that treatment (e.g. ovulation induction etc.) has started
  • Copies of follow up letters to relevant Diabetes team

If patient goes on the waiting list for IVF, then

Letter to Diabetes Physician (for Tayside or other Health Board as required- check name of physician from patient) regarding proposed treatment and indication of the length of waiting list. This will give them time to reach optimum control, while highlighting that spontaneous conception may still be possible while on waiting list. Ensure consent to disclosure form completed and signed by patient.

When patient reaches top of waiting list –respective Diabetes Physician to be informed again and wait for reply confirming stable blood sugars, before starting treatment. This includes patients from Tayside and all other Health Boards, and will be done by Consultant responsible for the patient when notes handed to them by Business Manager

When patient is pregnant - early pregnancy scan as routine

  • Copy letter following early pregnancy scan confirming viable pregnancy to Dr Gary Mires (N/W) / Dr Adam Gordon (PRI), Diabetes Physician and the relevant Diabetes Specialist Nurse for the Combined Antenatal Clinic at PRI/Ninewells as appropriate and requesting appointment at Combined Antenatal Clinic (for Tayside patients)
  • Copy of this to GP for other Health Boards.
  • This will allow the Diabetes Specialist Nurse to make contact with the patient, and allow for early booking in the Antenatal Clinic