Diabetes and pregnancy

Question 1

What is the target Hba1c for planning pregnancy?

Answer 1

Aim for <43mmol/mol

Question 2

What are some of the complications of diabetes during pregnancy?

Answer 2

The mother needs to be warned about increased risk of hypoglycaemia unawareness especially in the first trimester
Increased risk of pre eclampsia

Question 3

What are the detal complications of having a mother with diabetes?

Answer 3

Increased risk of miscarriage and malformation rates, this is reduced with good glycaemic control
Babies may be macroomic whichc increases risk of shoulder dystocia

Question 4

What should be done to reduce risk during antenatal and labour period?

Answer 4

During antenatal then should recieve care plan and joint review in clinic
Maintaining glycaemic control should be encouraged
Lots of detailed early scans to look for abnormalities
Labour should be in hospital with good antenatal care

Question 5

What is gestational diabetes?

Answer 5

Diabetes that develops during pregnancy

Question 6

What are the risk factors for gestational diabetes?

Answer 6

BMI >30
Previous macrosomic birth
Previous gestational diabetes
Ethnicity (south asian)
First degree relative with diabetes

Question 7

What is the management of gestational diabetes?

Answer 7

Should be managed by diet and exercise for 1-2 weeks

If not managed by the start oral hypoglycaemic medication

Question 8

What is the management of pre existing diabetes in pregnancy?

Answer 8

Stop oral hypoglycaemics apart from metformin and start insulin
Folic acid
Aspirin to reduce risk of pre eclampsia