Glucose Control During Labour and Delivery in Type 1 Diabetes - An Update on Current Evidence.

Purpose of Review: To provide an update on diabetes management during labour and delivery in women with type 1 diabetes with focus on appropriate insulin administration, carbohydrate supply and use of diabetes technology to support safe delivery and neonatal well-being.
Recent Findings: During active labour and elective cesarean section capillary blood glucose monitoring or continuous glucose monitoring at least hourly is recommended. Infusion with isotonic (5%) glucose can be given with adjustable infusion rate to address maternal carbohydrate requirements and to prevent maternal hypoglycemia. Subcutaneous insulin administration with multiple injections or insulin pump therapy is considered at least as safe and efficient as intravenous administration to obtain tight glycemic targets. Automated insulin delivery via insulin pump can be continued during labour and delivery. Diabetes management during labour and delivery involves intensive glucose monitoring, adequate insulin administration and carbohydrate administration to support safe delivery and neonatal well-being.
Competing Interests: Declarations. Human/Animal Studies Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing Interests: LR has received a grant (grant number: U1111-1209-6358) from Novo Nordisk A/S for the CopenFast trial, an investigator sponsored study. The salary of JCS is fully covered by the Grant number: U1111-1209-6358 from Novo Nordisk A/S. BWP and TDC declare no conflicts of interest. PD has participated in clinical studies on the use of insulin in pregnant women with preexisting diabetes in collaboration with Novo Nordisk, but no personal honorarium was involved. ERM has contracts with Novo Nordisk for the investigation of the Expect trial and the Evolve trial that are investigating newer insulin analogs and insulin pump treatment in pregnant women with diabetes, has received honoraria from Novo Nordisk for lectures, received support from Novo Nordisk for traveling to one international scientific meeting in the field of diabetes, and is participating an Advisory board for Novo Nordisk.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)