13. Management of Diabetes in Pregnancy

Preexisting Diabetes c Starting at puberty, preconception counseling should be incorporated into routine diabetes care for all girls of childbearing potential. A c Family planning should be discussed and effective contraception should be prescribed and used until a woman is prepared and ready to become pregnant. A c Preconception counseling should address the importance of glycemic control as close to normal as is safely possible, ideally A1C ,6.5% (48 mmol/mol), to reduce the risk of congenital anomalies. B c Women with preexisting type 1 or type 2 diabetes who are planning pregnancy or who have become pregnant should be counseled on the risk of development and/or progression of diabetic retinopathy. Dilated eye examinations should occur before pregnancy or in the first trimester, and then patients should be monitored every trimester and for 1 year postpartum as indicated by degree of retinopathy and as recommended by the eye care provider. B