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Diabetes in pregnancy

A Canadian clinical summary of diabetes in pregnancy, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Guideline No. 393: Diabetes in Pregnancy. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:SOGC 393

Source-attributed clinical priorities

  • Distinguish pre-existing diabetes from gestational diabetes and coordinate early obstetric and diabetes care for pre-existing disease.
  • Use the Canadian pregnancy screening and glucose-target framework, with nutrition, monitoring and medication individualized to the pregnancy.
  • Plan fetal surveillance, intrapartum glucose care and postpartum testing, including long-term type 2 diabetes prevention after gestational diabetes.
  • Targets and medication plans change in pregnancy, so connect pre-existing diabetes to specialist obstetric care early.
sources for this section:SOGC 393

Practical assessment and management workflow

1
Confirm diabetes type, glucose pattern, A1C, kidney and eye status, medicines and hypoglycemia awareness.
2
Provide nutrition and glucose-monitoring education and select pregnancy-compatible therapy.
3
Coordinate fetal anatomy, growth and maternal complication surveillance.
4
Plan intrapartum glucose management, postpartum medication change and infant feeding and glucose observation.
sources for this section:SOGC 393

Safety, red flags and urgent escalation

  • Diabetic ketoacidosis can occur at lower glucose levels in pregnancy and needs emergency treatment.
  • Severe hypoglycemia, vomiting, ketones or reduced fetal movement requires urgent assessment.
  • Stop teratogenic or insufficiently studied glucose-lowering and cardiorenal medicines under a safe replacement plan.
sources for this section:SOGC 393

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:SOGC 393

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:SOGC 393

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Society of Obstetricians and Gynaecologists of CanadaGuideline No. 393: Diabetes in Pregnancyaccessed 2026-08-20
    view source
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