You’ll encounter more patients with gestational diabetes...since rates have risen sharply in the past few years.
These patients develop diabetes during pregnancy, usually around the beginning of the 3rd trimester...leading to an increased risk of C-section, high birth weight, future diabetes, and other problems.
Many patients can manage gestational diabetes with lifestyle changes...such as a healthy diet and exercise.
But meds may be needed if blood sugars are still too high.
Expect insulin to be used first-line...since it has the longest track record. Plus oral meds aren’t always enough in these patients.
Watch for frequent dose increases with insulin...higher blood glucose levels are common as pregnancy progresses.
Patients who can’t or don’t want to inject insulin will likely get metformin...instead of other diabetes meds.
For example, glyburide is associated with more high-birth-weight babies than metformin or insulin. And there is a lack of long-term evidence with Jardiance, Victoza, etc.
Be ready to dispense standard blood glucose meters and supplies. There are limited data for continuous glucose monitors in gestational diabetes.
Ensure Rxs contain all info required by your pharmacy or the payer...such as the diagnosis code or testing frequency. Patients with gestational diabetes will usually check their blood sugar 4 times a day.
Find more ways to help in our resource, Dispensing Insulin and Other Injectable Diabetes Meds.
- Natl Vital Stat Rep. 2022 Jul;71(3):1-15
- Diabetes Care. 2022 Jan 1;45(Suppl 1):S232-S243
- Obstet Gynecol. 2018 Feb;131(2):e49-e64
- JAMA. 2021 Aug 10;326(6):531-538
- Am J Obstet Gynecol. 2018 May;218(5):B2-B4
- Chart: Comparison of Insulins (United States)
- Technician Tutorial: Dispensing Insulin and Other Injectable Diabetes Meds