A 30-year-old woman with type 1 diabetes attends the GP at 8 weeks of gestation. Her HbA1c at booking is 72 mmol/mol (8.7%). She is on a basal-bolus i...

Question

A 30-year-old woman with type 1 diabetes attends the GP at 8 weeks of gestation. Her HbA1c at booking is 72 mmol/mol (8.7%). She is on a basal-bolus insulin regimen. Which is the single most important action?

Accepted Answer

Refer urgently to the joint diabetes and antenatal clinic for intensive glucose management

Answer

Reassure that her diabetes control will improve naturally during pregnancy

Answer

Switch her insulin to metformin for better glucose control

Answer

Advise termination due to the high HbA1c and associated fetal risk

Answer

Defer referral until 12 weeks when the risk of miscarriage has passed

uk-drcog MCQ (SBA): Type 1 Diabetes in Pregnancy

A 30-year-old woman with type 1 diabetes attends the GP at 8 weeks of gestation. Her HbA1c at booking is 72 mmol/mol (8.7%). She is on a basal-bolus insulin regimen. Which is the single most important action?