Diabetes in Pregnancy

Question 1

Which diabetic drugs should be discontinued before pregnancy or as soon as an unplanned pregnancy is identified?

Answer 1

Oral anti-diabetic drugs, except metformin hydrochloride and substituted with insulin therapy.

Question 2

During the preconception period and during pregnancy in a woman with diabetes, how should their diabetes be managed?

Answer 2

Metformin hydrochloride as an adjunct or alternative to insulin

Question 3

For those with pre-existing type 2 diabetes, which anti-diabetic drug should be used after pregnancy and during breast feeding?

Answer 3

Metformin hydrochloride

All other anti-diabetic drugs should be avoided while breast feeding

Question 4

What anti-diabetic drug os the first choice for long-acting insulin during pregnancy?

Answer 4

Isophane insulin

Question 5

All women treated with insulin during pregnancy should be aware of the risks of (?), particularly in the first trimester.

Answer 5

Hypoglycaemia

Question 6

What should women with pre-existing diabetes, treated with insulin during pregnancy, do with their insulin immediately after birth?

Answer 6

Reduce the dose of insulin immediately after birth, as these women are at increased risk of hypoglycaemia.

Question 7

Gestational diabetes women who do not meet blood-glucose targets within 1-2 weeks with diet and exercise, may be prescribed?

Answer 7

Metformin hydrochloride

or

Insulin if metformin is contraindicated or not acceptable

Question 8

What should women who have a fasting plasma glucose above 7 mmol/litre at diagnosis be treated with?

Answer 8

Treat with insulin immediately, with or without metformin hydrochloride, in addition to a change in diet and exercise.

Question 9

What should women who have a fasting plasma glucose between 6 and 6.9 mmol/litre along with complications such as macrosomnia or hydraminos be considered for?

Answer 9

Consider treating with immediate insulin treatment, with or without metformin hydrochloride