Glycaemic targets before conception

Blood glucose concentrations are used to guide management, including adjusting insulin dosage, before and during pregnancy, with the aim of maintaining target concentrations and reducing glycaemic variability. For women with pre-existing diabetes using blood glucose concentration monitoring (eg capillary [finger-prick] checking), suggested blood glucose concentration targets in the pre-conception period are given in Suggested blood glucose concentration targets for women with pre-existing diabetes who are planning pregnancy.

Table 1. Suggested blood glucose concentration targets for women with pre-existing diabetes who are planning pregnancy[NB1]

Timing of blood sample

Blood glucose concentration target

fasting and preprandial

less than 6 mmol/L

1 hour postprandial

less than 8.5 mmol/L

2 hours postprandial

less than 7.5 mmol/L

Note:

NB1: These targets are a guide—individualise targets, aiming to avoid hypoglycaemia.

For women with pre-existing diabetes using continuous glucose monitoring (CGM) or flash glucose monitoring, the interstitial glucose concentration targets in the pre-conception period should be individualised by the patient’s diabetes specialist.

Glycated haemoglobin (HbA1c) is used to assess the glycaemic profile before and during pregnancy. The HbA1c should be as near to target as possible before conception, aiming for 48 mmol/mol (6.5%) or less while minimising the risk of hypoglycaemia.