Management of Diabetes in Pregnancy
Abstract
Diabetes in pregnancy is associated with risks to the woman and to the developing fetus. Miscarriage, pre-eclampsia,
preterm labour and congenital malformations in fetus are more common in women with pre-existing diabetes. Insulin
requirement increases with each trimester of pregnancy in diabetic females. Treatment of gestational diabetes consists
of medical nutrition therapy but insulin treatment forms the mainstay of the therapy. Monitoring glycemic control is
essential in treatment of gestational diabetes. HbA1c level is helpful to differentiate between a pre-GDM and GDM.
Majority of pregnant women with diabetes fail to achieve optimum glycemic control, mostly the postprandial plasma
glucose with conventional insulin. In them, the best option is to administer ultra-short-acting analogs, insulin lispro
or insulin aspart. These analogs improve the postprandial glucose control during pregnancy in both type 1 and type 2
diabetes and are considered safe and effective.