Global guideline on pregnancy and diabetes - International ...

<strong>Global</strong> Guideline on Pregnancy and Diabetes
Frequency of subsequent visits
Visits should be as frequently as required, depending on achievement of glycaemic
targets and management of other diabetes-associated or obstetric problems.
This may be monthly in the first two trimesters and more frequently thereafter.
Ongoing management of diabetes during pregnancy
Lifestyle management
Offer nutritional management and education. Advice should be individualized and
culturally sensitive, and should be administered by a healthcare professional, ideally
someone with specific expertise in medical nutrition therapy (MNT).
Offer general instruction about nutrition and specific advice about carbohydrate
intake, which wherever possible should include foods with a low glycaemic index.
If insulin is being used, then the choice, quantity and distribution of carbohydrate will
need to be coordinated with the amount, type and distribution of the varying insulin
requirements of pregnancy.
Encourage physical activity, tailoring advice to the previous exercise habits of the
individual. Explain that exercise can counter the decline in insulin sensitivity that
occurs during pregnancy and that resting will have the opposite effect.
Glucose control
Use HbA 1c
as an ancillary aid to self-monitoring. Aim for an HbA 1c