Pregnancy and Diabetes

Question 1

Pre-existing Diabetes: Preconception care

What are 2 things that may improve fertility

Answer 1

1) women who have irregular periods/PCOD who lose a lot of weight
2) who are on metformin or TZDs

Question 2

Pre-existing Diabetes: Preconception care

What A1C should women strive to achieve. To prevent what?

Answer 2

A1C ≤7 if possible ≤6.5% to prevent:

• preeclampsia
• spontaneous abortion
• congenital anomalies
• progression of retinopathy
• stillbirth

Question 3

Pre-existing Diabetes: Preconception care

What supplement should they start taking and when

Answer 3

folic acid 1mg at least 3 months preconception and continuing until 12 weeks of gestation

Question 4

Pre-existing Diabetes: Preconception care

What meds should be stopped

Answer 4

1) ACE and ARBs

2) statins

Question 5

Pre-existing Diabetes: Preconception care

What diabetes meds can be continued.
If women are on another antihyperglycemic meds, what should they switch to?

Answer 5

metformin and glyburide UNTIL pregnancy is achieved

Women on other antihyperglycemic agents, should switch to insulin prior to conception.