This protocol covers the management of type 1 diabetes (T1D) in a pregnant woman. Both maternal and fetal outcomes are worse in women with type 1 diabetes compared with women without diabetes, making tight glycaemic management throughout pregnancy a clinical priority.
Management centres on insulin therapy, used in combination with continuous glucose monitoring — the complete structured protocol, including how these interventions are applied and the specific clinical parameters involved, is available via the link below.
Both maternal and fetal pregnancy outcomes are worse in women with type 1 diabetes compared with women without diabetes.
Thus, women should be supported to achieve blood glucose ranges close to those seen in pregnant women without diabetes, with an HbA1c target of 48 mmol/mol (≤6.5%).
The Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT) showed that when CGM was used in conjunction with BGM, CGM was associated with better pregnancy outcomes and is widely recommended in Europe.
Women should aim for fasting and pre-meal glucose concentrations below 5.3 mmol/L (95 mg/dL), and postprandial values of below 7.8 mmol/L (140 mg/dL) 1 h after a meal and below 6.7 mmol/L (120 mg/dL) 2 h after a meal.
DOI: 10.2337/dci21-0043 View source ↗