Diabetes and Pregnancy

Publication Date: October 31, 2013

Last Updated: August 22, 2022

Preconception Care

1.1. The Endocrine Society (ES) recommends preconception counseling be provided to all women with diabetes who are considering pregnancy. ( 1 , L )

Preconception counseling can optimally be provided by a multidisciplinary team that includes the diabetes specialist, diabetes educator, dietitian, obstetrician, and other healthcare providers, as indicated.
If possible, and with the patient’s consent, the woman’s partner can be included as part of a supportive and mentoring therapeutic relationship.
Preconception counseling should include a discussion regarding:
- the need for pregnancy to be planned and to occur only when the woman has sufficient glycemic control, has had appropriate assessment and management of comorbidities including hypertension and retinopathy, has discontinued potentially unsafe (during pregnancy) medications, and has been taking appropriate folate supplementation beforehand
- the importance of smoking cessation
- the major time commitment and effort required by the patient in both self-management and engagement with the healthcare team, both before conception and during pregnancy
- the importance of notifying the healthcare team without delay in the event of conception.