Glycaemic management during labour for women with hyperglycaemia in pregnancy (including gestational diabetes)

Women with hyperglycaemia in pregnancy (including gestational diabetes) who are treated with insulin should have their insulin and, if applicable, metformin stopped with the onset of labour or when fasting for a caesarean section.

All women with hyperglycaemia in pregnancy (including gestational diabetes) should have their blood glucose concentrations measured every 2 hours during labour. If above target, women should be managed with insulin as for women with pre-existing type 2 diabetes; see Glycaemic management in women with type 2 diabetes during labour. However, most women with hyperglycaemia in pregnancy (including gestational diabetes) will not require insulin during labour.