If you are using continuous or flash glucose monitoring, the device will check your blood glucose levels throughout the day. Your care team should talk with you about when to do finger prick tests on top of this. Show If you are using testing strips, your care team should talk with you about when to test your blood glucose levels during the day: Diabetes type and treatment When should I test? Women with type 1 diabetes
Women with type 2 diabetes or gestational diabetes having 2 or more insulin injections a day
Women with type 2 diabetes or gestational diabetes having any of the following:
Blood glucose target levelsYou and your care team should agree ideal (or target) blood glucose levels that are right for you and are manageable without causing problems with hypoglycaemia. If you are taking metformin, or you are on insulin, you should be advised to aim for the following target blood glucose levels, unless this leads to difficulties with hypoglycaemia:
If you are not able to test until 2 hours (rather than 1 hour) after a meal, the target glucose level at that time should be below 6.4 mmol/litre. If you are on insulin, you should also be advised to keep your blood glucose above 4 mmol/litre, because of the risk of hypoglycaemia. HbA1c levelsAn HbA1c test tells you your average blood glucose levels over the last 2 to 3 months.
Managing your blood glucose levels if you are on insulinYour care team will review your insulin treatment with you, and may suggest a different type to help you achieve your blood glucose targets. Your care team should explain how being pregnant can make it harder for you to recognise hypoglycaemia, especially in the first 3 months. You should make sure you have fast‑acting forms of glucose, such as sugar‑containing drinks or dextrose tablets, to hand in case your blood glucose gets too low. If you have type 1 diabetes, your care team should also provide you with glucagon. This can be injected to increase your blood glucose in an emergency. Your partner or family members should be shown how to do this. If you are finding it hard to keep your blood glucose at the right level or hypoglycaemia is affecting your day‑to‑day activities, you may be offered an insulin pump (a small device that delivers a steady flow of insulin through a fine tube inserted under the skin) instead of injections. American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S17-S38. PMID: 34964875pubmed.ncbi.nlm.nih.gov/34964875/. Committee on Practice Bulletins--Obstetrics. Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49-e64. PMID: 29370047pubmed.ncbi.nlm.nih.gov/29370047/. Landon MB, Catalano PM, Gabbe SG. Diabetes mellitus complicating pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 45. Metzger BE. Diabetes mellitus and pregnancy. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 45. Moore TR, Hauguel-De Mouzon S, Catalono P. Diabetes in pregnancy. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 59. Last reviewed on: 4/19/2022 Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. |