Advances in clinical management of pregnant women with preexisting diabetes

Abstract

Pregnant women with preexisting diabetes have increased adverse maternal and neonatal outcomes. Preconception planning is necessary for avoiding unintended pregnancies and mitigating risk of congenital defects. The recommended glycosylated hemoglobin goals are <6.5% before conception and <6.0% during pregnancy. Screening and management for diabetic complications are critical, strict blood pressure control goal need to be achieved, especially for those complicated by nephropathy. Continuous glucose monitoring during pregnancy might help improve blood glucose control for women with type 1 diabetes. Insulin is still the first-line therapy for pregnant women with preexisting diabetes. Optimization of glycemic control, appropriate medication regimens and close attention to comorbidities can help minimize the maternal and neonatal adverse outcomes and ensure the quality of clinical management for women with preexisting diabetes before, during, and after pregnancy. Key words: Diabetes, gestational; Preconception care; Prenatal care; Postnatal care; Patient care; Clinical protocols