Fast Five Quiz: Type 2 Diabetes and Pregnancy

Anne L. Peters, MD

Disclosures

May 11, 2022

Preconception counseling and family planning should be discussed with women of reproduction age. All women with type 2 diabetes should be educated on the importance of achieving and maintaining near euglycemia prior to conception and throughout pregnancy. During pregnancy, organogenesis occurs at 5-8 weeks of gestation; studies have demonstrated that optimizing glycemia with a hemoglobin A1C of < 6.5 is associated with a lower risk for congenital anomalies, preeclampsia, and preterm birth.

The presence of background retinopathy is not a contraindication to pregnancy, but because pregnancy can worsen retinopathy, it is important for this patient to have frequent follow-up with an ophthalmologist during pregnancy.

Although weight loss is always desirable in obese individuals, at 40 years of age, fertility is a consideration. The patient should begin working with a dietitian to establish healthy eating habits both before and during pregnancy. A multidisciplinary group focused on improving glycemic control from preconception through pregnancy has been shown to improve diabetes and pregnancy outcomes. While diet is an important component to lifestyle management, eliminating all carbohydrates is not optimal for pregnancy.

Learn more about type 2 diabetes.

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