ABSTRACT
This chapter outlines the management plan applies equally to women with established diabetes as well as to those with gestational diabetes. During pregnancy, diabetic women are generally cared for in a combined obstetric/diabetic clinic. The obstetric and diabetes specialist registrars should be informed of the labouring diabetic woman’s admission to the labour ward. Women with established diabetes should have their insulin dose reduced by 50% at delivery of placenta. They should be converted to a subcutaneous regimen when eating and drinking normally. Insulin should be stopped post-delivery in those women in whom the diagnosis of gestational diabetes is clear. The baby will be seen and examined by the paediatrician at birth and, as with all other deliveries, a sample of venous and arterial cord blood will be obtained following delivery and the following tests performed: cell volume, haematocrit, levels and blood.
