Treatment

Dietary modification, the use of diabetic plate

Pharmacological treatment

Mixed Insulin shots 2/3 morning and 1/3 before bed according to Gestational Age.

1st trimester-0.5IU/kg to 0.7IU/kg.

2nd trimester-0.8IU/kg to 1IU/kg.

Hospital treatment continues until when the target glycemic level is met.

Target glycemic levels

Pre prandial target is  btn 3.5 to 5.5mmol/l and Post prandial target is btn 5 to 7.5mmol/l. Thereafter, patient can continue with home treatment with insulin or oral antiglycemics after proper dietary and lifestyle education is given. Apart mfrom glibenclamide and metformin other antiglycemics are contraindicated.

Mode of delivery

It depends on maternal and fetal condition in total absence of complications with good glycemic control, SVD can be done, otherwise C/S is highly recommended in any non-reassuring maternal or fetal condition.