Decreasing Insulin Requirements in Pregnancy With Pre-existing or Gestational Diabetes: Management Practices Across Canada

Decreasing insulin requirements in pregnant women with preexisting or gestational diabetes has been attributed to placental insufficiency, which results in increased surveillance or early delivery. This practice is not evidence based. A 5-item questionnaire was administered electronically to a convenience sample of Canadian resident and staff obstetrician-gynaecologists and maternal–fetal medicine specialists. Practice patterns varied widely among the 142 survey respondents, and this variation did not correlate to their level of training. There is a paucity of evidence to guide the management of patients with decreasing insulin requirements, which is reflected in varied and possibly unnecessary clinical interventions.