DIABETES MELLITUS-GESTATIONAL DIABETES

SUMMARY

1. With pregnancy in diabetic women, strict control even before conception is important. Maintain FPG < 100 mg/dL and HbA1c < 7%.

2. Tight glycemic control decreases the risk of macrosomia and shoulder dystocia in the newborn.

3. During pregnancy, a diabetic patient requires 50% more insulin due to increased resistance from placental hormones. This increased requirement is gone immediately after delivery.

4. Statins, ACEI, ARB, hypoglycemics should be discontinued before pregnancy. Use insulin instead.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].