perinatal
and
later
complications (Metzger 2007,
Combs 2011, Herandez 2011,
Rowan 2011 as cited in
Crowther, 2015).
Fasting and Pre-prandial
capillary blood glucose
upper level limit
≤ 5.0 mmol/
2
hours
Post-prandial
capillary blood glucose
upper level limit
≤ 6.7 mmol/L
These targets are used as a
guide to treatment in
CMDHB. With Type 1
diabetes in pregnancy,
individual targets are set.
Hypoglycaemia
Diabetes in Pregnancy
treatment objective is to
achieve glycaemic control
and reduce the risk of
perinatal
complications
without
serious
hypoglycaemia, the major
adverse effect of insulin
therapy
In pregnancy a CBG level <
3.5
is
classified
as
hypoglycaemia with GDM
or Type 2 diabetics on
Insulin, whereas with Type
1 diabetes treatment is
December 2017 L.O.G.I.C.
required when CBG reading
<4.0.
Women are supported by
the DIP team throughout
their
pregnancies
to
achieve the best possible
outcome for their long-term
health and for the health of
their babies. On diagnosis
of the pregnancy the
woman
should
be
commenced on treatment if
necessary and referred to
local diabetes in pregnancy
service as soon as possible.
References:
Annual Report of the Perinatal
and Maternal Mortality Review
Committee: Reporting on
mortality 2015. Wellington:
Health Quality & Safety
Commission.
https://www.hqsc.govt.nz/asse
ts/PMMRC/Publications/Ninth-
PMMRC-report-FINAL-Jun-
2015.pdf
Australasian Diabetes in
Pregnancy Society (ADIPS)
Consensus Guidelines for the
Management of Type 1 and
Type 2 Diabetes in Relation to
Pregnancy. (2005).
https://www.mja.com.au/journ
al/2005/183/7/australasian-
diabetes-pregnancy-society-
consensus-guidelines-
BPACNz.ltd. 2011. Pre
Conception Care in General
Practice. Best Practice Journal,
35 (April). 9-14.
http://www.bpac.org.nz/BPJ/2
011/april/preconception.aspx
BPACNZ.ltd. 2015. Monitoring
Diabetes Before During and
After Pregnancy. Best Tests,
(July). 2-12.
http://www.bpac.org.nz/BT/20
15/July/diabetes.aspx
Campbell, I.W., Nairn, M.,
(2008), Scottish Collegiate
Guidelines Network:
Management of Diabetes (SIGN
55), The British Journal of
Diabetes and Vascular Disease,
DOI:10
1177/14746514020020010501
PMMRC. 2017. Eleventh
Crowther, C., (2014), Optimal
glycaemic targets for
gestational diabetes, TARGET
trial protocol, University of
Auckland
Ekeroma, Chandran, McCowan,
Ansell, Eagleton & Kenealy.
(2014). Impact of using the
international association of
diabetes and pregnancy study
groups criteria in South
Auckland: prevalence,
interventions and outcomes.
ANZJOG.
DOI:10.1111/ajo.12267
management-type-1
33