Preconception care for women with type 1 diabetes

To emphasize preconception care of women with type 1 diabetes and the role of primary care physicians in evaluating and counseling them. Substantial level II evidence indicates that tight glycemic control before conception and early in pregnancy reduces the rate of congenital malformations. Most evi...

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Bibliographic Details
Published in:Canadian family physician 2003-06, Vol.49 (6), p.769-773
Main Authors: Klinke, Jennifer, Toth, Ellen L
Format: Article
Language:English
Subjects:
Adult
Congenital Abnormalities
Counseling
Diabetes
Diabetes Mellitus, Type 1 - drug therapy
Family medicine
Female
Health care
Humans
Physician's Role
Pregnancy
Pregnancy in Diabetics
Prenatal Care
Primary Health Care
Risk Factors
Women
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Summary:To emphasize preconception care of women with type 1 diabetes and the role of primary care physicians in evaluating and counseling them. Substantial level II evidence indicates that tight glycemic control before conception and early in pregnancy reduces the rate of congenital malformations. Most evidence concerning maternal and fetal risks during pregnancy in patients with type 1 diabetes is level III or IV. Little is published on the role of family physicians in providing preconception counseling or care. Preconception care is effective in improving glycemic control early in pregnancy and in reducing the rate of congenital malformations. Preconception evaluation of type 1 diabetic patients involves assessment of prepregnancy glycemic control and diabetic complications. Preconception counseling includes discussing the rate of transmission of diabetes, the effects of pregnancy on maternal and fetal complications, and the use of contraception until optimal glycemic control can be attained. Primary care physicians often have frequent and early contact with women of reproductive age; they are ideal candidates for providing type 1 diabetic women with preconception evaluation and counseling.
ISSN:0008-350X
1715-5258