Diabetes & pregnancy during the COVID-19 pandemic
25 April, 2020
The Coronavirus pandemic will not end when the isolation order ends and although circulation through the streets will be permitted with the appropriate protective measures, pregnant women must continue to avoid contagion like the rest of the population.
At Instituto Bernabeu, following WHO recommendations and those of Scientific Societies, we have established criteria for the care of pregnant women with diabetes with the aim of continuing to adequately follow this problem, with minimal exposure for pregnant women.
In the case of Gestational Diabetes, we recommend avoiding O’Sullivan’s diagnostic tests and the blood glucose curve for the time being. Both require a 1-3 hour stay in a health center. We recommend replacing it with a combination of fasting glucose and glycated hemoglobin (HbA1c), which measures the average glucose for the last 3 months.
Endocrinology visits in cases with Diabetes & Pregnancy are preferably carried out “virtually”.
Both in women with diabetes prior to pregnancy, and in women with Gestational Diabetes (detected in pregnancy), the use of continuous glucose monitoring is encouraged by means of the flash system and remote control of glucose profiles using the appropriate platform. Through this system, the professional has access to the patient’s blood glucose controls and can make the appropriate treatment adjustments immediately.
In women with Gestational Diabetes who give birth during this period, postpartum re-evaluation is still important, but from all scientific societies it is considered appropriate to delay it (without exceeding the postpartum year), since it requires a glucose overload and the patient must remain in the health center for 2 hours.
Sources
1. Actualización Urgente: alternativa temporal para el diagnóstico de hiperglucemia gestacional y el seguimiento de estas mujeres y aquellas con diabetes pregestacional durante la pandemia Covid-19. Consenso del Grupo Español de Diabetes y Embarazo (GEDE), de la Sociedad Española de Diabetes (SED) y la Sección de Medicina Perinatal (SEMEPE) de la Sociedad Española de Ginecología y Obstetricia (SEGO). Abril 2020.
2. Ministerio de sanidad, Consumo y Bienestar Social. Manejo de la mujer embarazada y el recién nacido con COVID-19. Marzo 2020. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Documento_manejo_embarazo_recien_nacido.pdf
Dr Navarro, Endocrinology and Nutrition director of Instituto Bernabeu