What are the typical glucose targets during pregnancy for a patient with diabetes?

• A. Fasting <95 mg/dL; 1-hour postprandial <140 mg/dL; 2-hour postprandial <120 mg/dL.
• B. Fasting <110 mg/dL; 1-hour postprandial <180 mg/dL; 2-hour postprandial <150 mg/dL.
• C. Fasting <85 mg/dL; 1-hour postprandial <120 mg/dL; 2-hour postprandial <160 mg/dL.
• D. Fasting <100 mg/dL; 1-hour postprandial <150 mg/dL; 2-hour postprandial <200 mg/dL.

Answer: (A)

Tight glucose targets during pregnancy are chosen to minimize the fetus’s exposure to maternal glucose and reduce complications for both mother and baby. Keeping fasting glucose under 95 mg/dL helps prevent overnight maternal hyperglycemia, which translates into steadier glucose transfer to the fetus. Limiting the 1-hour postprandial value to under 140 mg/dL reduces the peak after meals, lowering the risk of fetal hyperglycemia and the resulting excessive fetal insulin production. Keeping the 2-hour postprandial value under 120 mg/dL further limits overall glucose exposure in the hours after eating, which helps prevent macrosomia and associated delivery complications.

These targets reflect the goal of achieving good glycemic control throughout the day, across fasting and post-meal periods, to decrease common pregnancy-related risks such as large-for-gestational-age babies and neonatal hypoglycemia. While guidelines can vary slightly, this combination—fasting under 95, 1-hour postprandial under 140, and 2-hour postprandial under 120 mg/dL—is a commonly recommended set for pregnant patients with diabetes.