Diabetes in pregnancy

Question 1

Women with T2DM wants to get pregnant, what advice would you offer her?

Answer 1

Advise good blood glucose control (<48mmol/mol)
Advise contraception until good blood glucose control
Give structured education plan - diet etc.

Question 2

What assessments should you offer to women with diabetes who want to get pregnant?

Answer 2

Retinal assessment - digital imaging with mydriasis using tropicamide

Renal assessment - albuminuria, serum creatinine, eGFR, urine creatinine ratio

Question 3

Target blood glucose for diabetics during pre-conception period

Answer 3

1. a fasting plasma glucose level of 5–7 mmol/litre on waking and
2. a plasma glucose level of 4–7 mmol/litre before meals at other times of the day.

Question 4

Target blood glucose for diabetics while pregnant

Answer 4

fasting: 5.3mmol/L and
1 hour after meals: 7.8 mmol/L or
2 hours after meals: 6.4 mmol/L

Question 5

4 drugs for patients who are diabetic

Answer 5

High dose folic acid
Isophane insulin
Metformin
Glibenclamide

Question 6

Drugs you have to stop for diabetes who become pregnant

Answer 6

ACE-i
Statin
ARB
Other hypoglycemics except metformin

Question 7

Actions to take for women with pre-existing diabetes

Answer 7

Stop ACE-i, statin and ARB

Stop other hypoglycemics except metformin