Management of Diabetes during pregnancy

Gestational Diabetes

Pregnancies complicated by gestational diabetes which is diet-controlled should be managed as follows:

Office visits to the doctor at least every other week until 36 weeks then every week.
Daily self-blood glucose monitoring with fasting and 1-hr post-meal blood sugars initially; if target range blood sugars are obtained then testing may be decreased to 4 finger sticks on 2 or 3 days per week.
An ultrasound at around 30-32 weeks to see if the baby is growing normally and another one prior to delivery at about 38 weeks to estimate the baby's weight.
Delivery should be planned near the due date and should not be allowed to extend too far beyond this.
Twice a week non stress tests (fetal monitoring) should be started if the pregnancy is allowed to continue past 40 weeks.

Office visits to the doctor at least every other week until 36 weeks and weekly thereafter.
Daily self-blood glucose monitoring with fasting and 1-hr post-meal blood sugars for the remainder of the pregnancy.
Insulin therapy usually combining insulins with different rate of action with subcutaneous injections at least 2 to 3 times per day. Click here for more information on insulin.
An ultrasound at around 30-32 weeks to see if the baby is growing normally and another one prior to delivery at about 38 weeks to estimate the baby's weight.
Delivery should be planned around the due date and should not be allowed to extend too far beyond this.
Twice a week non stress tests (fetal monitoring) should be started at around 32 -34 weeks unless clinically indicated for other obstetrical reasons sooner than this.

Office visits to the doctor at least every other week until 36 weeks and weekly thereafter.
Daily self-blood glucose monitoring with fasting and pre-meal blood sugars for the remainder of the pregnancy.
Initial laboratory studies in addition to prenatal labs will include a complete metabolic panel, thyroid function studies, a 24 hr urine collection to evaluate kidney function and an opthamological retinal (eye) examination.
Insulin therapy usually combining insulins with different rate of action with subcutaneous injections at least 2 to 3 times per day.
An ultrasound at around 30-32 weeks to see if the baby is growing normally and another one prior to delivery at about 38 weeks to estimate the baby's weight.
Delivery should be planned around the due date and should not be allowed to extend too far beyond this.
Twice a week non-stress tests (fetal monitoring) should be started at around 28 - 32 weeks depending on the severity of vascular complications from the diabetes.