A 35-year-old woman with type 2 diabetes - user_10

[ArchivalUser]

Q. A 35-year-old woman with type 2 diabetes comes to your office seeking pregnancy advice. Although she is not currently pregnant and has never been pregnant, she and her spouse are planning to have their first child. She has previously managed her diabetes with diet and exercise. Approximately 4 months ago, however, you started her on metformin, as her fasting blood glucose levels were consistently elevated. Her hemoglobin A1c level at that time was 9%. She has no specific complaints today and her physical examination is unremarkable. A hemoglobin A1c level drawn 1 week before today's visit is 6.2%. She would like to know which, if any, diabetic medications she can take during her pregnancy. Which of the following is the most appropriate pharmacologic monotherapy for her?

A. Acarbose
B. Glyburide
C. Insulin
D. Metformin
E. No medication, continue diet and exercise

[ArchivalUser]

CC- insulin

[ArchivalUser]

Glycated hemoglobin (A1C) values, which reflect the average blood glucose concentration over the previous 8 to 12 weeks, are useful in evaluating a woman's glycemic control before conception and throughout pregnancy. To keep this in mind her A1c level is 6.2% but e Metformin not e diet alone so in order to prevent boosting of Blood sugar again we stop metformin and start her on Insulin.

Insulin is the only drug safe for type 1/11 and GSM.

If its failed in case of GDM you can start e Glyburide although it crosses the placenta in less amount, by that time means late half/ early T3 it would not create critical problem for baby as organogenesis would already has occurred.

[ArchivalUser]

Thank you