Endocrine: Diabetes, pregnancy and breastfeeding

Question 1

Women with pre-existing diabetes who are planning to become pregnant should be advised to take folic acid at the dose for women who are at high-risk of conceiving a child with a neural tube defect, which is what?

Answer 1

5mg daily until week 12.

Question 2

All oral antidiabetic drugs should be discontinued before pregnancy and substituted with insulin therapy. Apart from what?

Answer 2

Metformin.

Question 3

What oral antidiabetic drugs can be used during breastfeeding?

Answer 3

Women with pre-existing diabetes who are planning to become pregnant should be advised to take folic acid at the dose for women who are at high-risk of conceiving a child with a neural tube defect,

Question 4

What is the first-choice for long-acting insulin during pregnancy?

What are the exceptions?

Answer 4

Isophane insulin.

Women who have good blood-glucose control before pregnancy with long-acting insulin analogues such as insulin detemir or insulin glargine, can continue on them.

Question 5

Women with gestational diabetes who have a fasting plasma glucose below __mmol/litre at diagnosis, should first attempt dietary and execise alone to reduce BG.

Answer 5

7mmol/litre

Question 6

Women who have a fasting plasma glucose above __mmol/litre at diagnosis should be treated with insulin immediately, with or without metformin hydrochloride, in addition to a change in diet and exercise.

Answer 6

Women who have a fasting plasma glucose above 7 mmol/litre at diagnosis should be treated with insulin immediately, with or without metformin hydrochloride, in addition to a change in diet and exercise.

Question 7

What drug may be considered for women from 11 weeks gestation (after organogenesis) who cannot tolerate metformin, or for those in whom metformin is not effective and do not wish to have insulin therapy?

Answer 7

Glibenclamide