GuidelineDiabetic medicine : a journal of the British Diabetic Association2022
Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes - an updated guideline from the Joint British Diabetes Society for Inpatient Care.
Guideline in Diabetic medicine : a journal of the British Diabetic Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies.Diabetes, obesity & metabolism · 2026Pooled it
- Intrapartum maternal glycaemic control for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- Continuous Glucose Monitoring in Gestational Diabetes Mellitus: Evidence, Clinical Benefits and Remaining Challenges.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Streamlining intrapartum glycemic control: Subcutaneous insulin for intrapartum diabetes management.Pregnancy (Hoboken, N.J.) · 2026Article
- Drug-induced hyperglycemia in obstetrics: key offending drugs, mechanisms, and practical management.Frontiers in pharmacology · 2026Review
- Challenges in glycaemic control among women with type 1 diabetes and the role of MiniMed 780G system: A narrative review.Diabetes, obesity & metabolism · 2026Review
- Practical Approach to Continuous Glucose Monitoring Interpretation and Automated Insulin Delivery Use in Pregnancy: Considerations for Obstetric Providers.Journal of diabetes science and technology · 2026Article
- Proactive Insulin Escalation for Antenatal Betamethasone-Induced Hyperglycaemia in Women With Diabetes: A Prospective Cohort Study.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Article
- Managing diabetic ketoacidosis in special conditions: Difficulties and dilemmas.World journal of diabetes · 2025Review
- Development of insulin and its pharmacology and perioperative use: a narrative review.British journal of anaesthesia · 2025Review
- Evaluation of a Standardized Obstetrics Insulin Drip Protocol and Order Set.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Continuous Glucose Monitoring Within Hospital: A Scoping Review and Summary of Guidelines From the Joint British Diabetes Societies for Inpatient Care.Journal of diabetes science and technology · 2023Article
- Insulin Pumps and Hybrid Close Loop Systems Within Hospital: A Scoping Review and Practical Guidance From the Joint British Diabetes Societies for Inpatient Care.Journal of diabetes science and technology · 2023Article
- Adoption of a pregnancy-specific intravenous insulin protocol (Pregnancy-IVI) at a regional centre has equivalent safety and efficacy outcomes as a tertiary hospital.Diabetic medicine : a journal of the British Diabetic Association · 2023Article
- Management of type 2 diabetes in pregnancy: a narrative review.Frontiers in endocrinology · 2023Review
- Accuracy of Continuous Glucose Monitoring in Pregnancy During Inpatient Acute Glycemic Variability in Women with Type 1 Diabetes Mellitus.Journal of diabetes science and technology · 2023Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article summarises the Joint British Diabetes Societies for Inpatient Care guidelines on the management of glycaemia in pregnant women with diabetes on obstetric wards and delivery units, Joint British Diabetes Societies (JBDS) for Inpatient Care Group, ABCD (Diabetes Care) Ltd. The updated guideline offers two approaches - the traditional approach with tight glycaemic targets (4.0-7.0 mmol/L) and an updated pragmatic approach (5.0-8.0 mmol/L) to reduce the risk of maternal hypoglycaemia whilst maintaining safe glycaemia. This is particularly relevant for women with type 1 diabetes who are increasingly using Continuous Glucose Monitoring (CGM) and Continuous Subcutaneous Insulin Infusion (CSII) during pregnancy. All women with diabetes should have a documented delivery plan agreed during antenatal clinic appointments. Hyperglycaemia following steroid administration can be managed either by increasing basal and prandial insulin doses, typically by 50% to 80%, or by adding a variable rate of intravenous insulin infusion (VRIII). Glucose levels, either capillary blood glucose or CGM glucose levels, should be measured at least hourly from the onset of established labour, artificial rupture of membranes or admission for elective caesarean section. If intrapartum glucose levels are higher than 7.0 or 8.0 mmol/L on two consecutive occasions, VRIII is recommended. Hourly capillary blood glucose rather than CGM glucose measurements should be used to adjust VRIII. The recommended substrate fluid to be administered alongside a VRIII is 0.9% sodium chloride solution with 5% glucose and 0.15% potassium chloride (KCl) (20 mmol/L) or 0.3% KCl (40 mmol/L) at 50 ml/hr. Both the VRIII and CSII rates should be reduced by at least 50% after delivery.
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