Medical Care for pregnancies complicated with diabetes.

This is the utmost important part of the management of pregnancies complicated with diabetes. Ideally this should be started preconceptionally. If a reduction in diabetes-associated neonatal morbidity is to be achieved, counsel the patient before conception and perform a medical risk assessment in all women with overt diabetes and those with a history of GDM during a previous pregnancy.

Followings are the key points which should be addressed in management of pregnancies complicated with diabetes.



1. Complete assessment of cardiovascular, renal and ophthalmologic status of the patient.

2. Frequent and regular monitoring of both pre-prandial and post-prandial capillary glucose level.


3. Following blood sugar levels should be achieved in order to have a safe pregnancy period and outcome.

I. Fasting blood glucose < 105 mg/dl (5.8mmol/l)
II. One-hour postprandial plasma glucose less than 155 mg/dl (8.6mmol/L)


4. The insulin regimen should result a smooth glycemic profile without any hypoglycemic attacks.

5. Patients should take a prenatal vitamin containing at least 1 mg/d folic acid for at least 3 months prior to conception to minimize the risk of neural tube defects in the fetus.


6. Urge nonpregnant patients to continue avoidance of pregnancy until their HbA1C value is in within the reference range (<6.5%).