Managing Blood Sugar Levels During Pregnancy and Postpartum
This helpful guide by Dr. Donna D. Johnson provides detailed insights on managing blood sugar levels for women with gestational diabetes mellitus (GDM), type 2 diabetes, and type 1 diabetes during pregnancy and postpartum. It covers medication adjustments, monitoring criteria, and specific recommendations for each diabetes type to ensure optimal blood sugar control and maternal health throughout the perinatal period.
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Presentation Transcript
HOW TO MANAGE BLOOD SUGAR INTRAPARTUM AND POSTPARTUM Donna D. Johnson, MD
GDM Take evening medication Do not take morning medication Manage IP with a sliding scale Postpartum: Check fasting BS Patient usually does not need medication
GDM If fastings < 100: non diabetic If fastings >126: diabetic If in between needs 2 hour 75 gram GTT <140 normal > 200 diabetic In between prediabetic
TYPE 2 DIABETES Take usual dose of intermediate or short acting insulin with dinner Long acting should be cut in half Intrapartum can manage with insulin drip
TYPE 2 DIABETES Postpartum: Stop insulin if they were on medication prior to pregnancy. Restart pre-pregnancy medication when eating If were on insulin give them about a third of the pregnancy dose Breastfeeding decreases insulin requirements
COMMON DRUGS Metformin: Compatible Glyburide: Probably Compatible Avandia: Probably Compatible Januvia: Probably Compatible GLP-1: Probably Compatible Invokana: Not Compatible
TYPE 1 DIABETES Take usual dose of intermediate or short acting insulin with dinner Long acting should be cut in half Intrapartum insulin drip recommended
TYPE 1 DIABETES PPD #1: honeymoon 1/3 of pregnancy dose of pre-pregnancy dose Usually start long acting and cover meals with short acting
