Managing Preexisting Diabetes for Pregnancy

A. Organization of preconception and pregnancy care Recommendations • Women with diabetes and childbearing potential should be educated about the need for good glucose control before pregnancy and should participate in effective family planning.(E) • Whenever possible, organize multidiscipline patient-centered team care for women with preexisting diabetes in preparation for pregnancy.(B) • Women with diabetes who are contemplating pregnancy should be evaluated and, if indicated, treated for diabetic nephropathy, neuropathy, and retinopathy, as well as cardiovascular disease (CVD), hypertension, dyslipidemia, depression, and thyroid disease.(E) • Medication use should be evaluated before conception, since drugs commonly used to treat diabetes and its complications may be contraindicated or not recommended in pregnancy, including statins, ACE inhibitors, angiotensin II receptor blockers (ARBs), and most noninsulin therapies.(E) • Continue multidiscipline patientcentered team care throughout pregnancy and postpartum.(E) • Regular follow-up visits are important