Comments on “Preconception care of Saudi women with diabetes mellitus”

One of the most common complications of diabetes mellitus is the ocular condition that pregnancy modifies.[2] Gestational diabetes poses a very low risk for the development of retinopathy. In patients who have nonproliferative diabetic retinopathy (DR), studies have demonstrated that as many as 50% may show an increase in their nonproliferative retinopathy. Approximately 5‐20% of these patients develop proliferative changes. An ophthalmologic examination at least once every trimester is recommended. Studies on patients with proliferative DR have shown that there could be a progression of the disease in as many as 45%. In patients with proliferative DR, monthly ophthalmic examinations are warranted. Proliferative DR may regress at the end of the third trimester or postpartum. A cesarean section should be considered for patients with proliferative DR to prevent vitreous hemorrhage resulting from Valsalva maneuver used during labor. Diabetic macular edema may develop or worsen during pregnancy.[3]