Diabetes in Pregnancy Author: Elisha L. Brownfield, MD
Editorial changes - 2009-10-30
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Consultation for Management
  • Ensure specialized obstetric care for diabetic women who are pregnant or planning pregnancies.
  • Consider consultation with an endocrinologist and other professionals to ensure ideal glucose levels before and during pregnancy in diabetic women.
  • Obtain specialty consultation for help in managing complications of diabetes in pregnant women or before conception.

Ensure specialized obstetric care for diabetic women who are pregnant or planning pregnancies. C

  • Refer all women with pregestational diabetes to an obstetrician, or a high-risk obstetrician if available, as soon as pregnancy is diagnosed.
  • Consider referral to a high-risk obstetrician for:
    • Fetal and maternal risk determination as part of pregnancy planning
    • Ongoing management if pre-conception fasting whole-blood glucose levels of 70 to 100 mg/dL and 2-hour postprandial levels of <140 mg/dL cannot be achieved before conception
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Consider consultation with an endocrinologist and other professionals to ensure ideal glucose levels before and during pregnancy in diabetic women. C

  • Consider referral to an endocrinologist if the diabetic woman cannot achieve ideal glucose levels during pregnancy or before conception.
  • Refer all women with diabetes during pregnancy, or women with diabetes considering pregnancy, to a:
    • Nutritionist for instruction on the American Diabetes Association diet
    • Certified diabetic educator for instruction in self-management of diabetes
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Obtain specialty consultation for help in managing complications of diabetes in pregnant women or before conception. C

  • Obtain consultation with a:
    • Nephrologist if proteinuria is detected in a pregnant patient
    • Ophthalmologist for management of diabetic retinopathy
    • Cardiologist in pregnant patients with coronary artery disease
    • Neurologist in women with neuropathy or autonomic dysfunction
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FAQs
Elisha L. Brownfield, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.

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