Update on management of diabetes in pregnancy

Intisar Alem

Diabetes in pregnancy is associated with risks to the woman and to the developing fetus it’s affected by pregnancy and affects the course of the pregnancy itself
Pregnancy outcomes for women with diabetes and their babies are poor compared to those women who do not have diabetes. Diabetes during pregnancy increases fetal and maternal morbidity and mortality. Miscarriage, pre-eclampsia and preterm labours are more common in women with pre-existing diabetes. In addition, diabetic complications (retinopathy & nephropathy) worsen rapidly during pregnancy.
Stillbirth, spontaneous abortion, congenital malformations, macrosomia, birth injury, perinatal mortality and Neonates are at risk of respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia, and hyperviscosity
Pregnancy makes diabetes much harder to control, blood sugar and the need for insulin rise throughout pregnancy. So more effort is needed, home monitoring & intensified insulin regimens (multiple dose regimens of subcutaneous long-acting and short-acting insulins or continuous subcutaneous insulin infusion [CSII]) usually achieves the best results.
Preconception care and good glucose control before and during pregnancy can reduce these risks
Pre pregnancy counselling and multidisciplinary team management with regular follow-up visits (before, during, and after pregnancy) is the key for achieving good pregnancy outcomes.