Managing preexisting diabetes for pregnancy

Kitzmiller, John L.; Block, Jennifer M.; Brown, Florence M.; Catalano, Patrick M.; Conway, Deborah L.; Coustan, Donald R.; Gunderson, Erica P.; Herman, William H.; Hoffman, Lisa D.; Inturrisi, Maribeth; Jovanovic, Lois B.; Kjos, Siri I.; Knopp, Robert H.; Montoro, Martin N.; Ogata, Edward S.; Paramsothy, Pathmaja; Reader, Diane M.; Rosenn, Barak M.; Thomas, Alyce M.; Kirkman, M. Sue

doi:10.2337/dc08-9020

Cited by 476Gestational Diabetes Research and ManagementPregnancy and Medication ImpactDiabetes Management and Research

Managing preexisting diabetes for pregnancy

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Kitzmiller, John L., Block, Jennifer M., Brown, Florence M., Catalano, Patrick M., Conway, Deborah L., Coustan, Donald R., Gunderson, Erica P., Herman, William H. +12 more·2008·Diabetes Care

DOI 10.2337/dc08-9020PMC PMC2930883

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Abstract

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

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Stringent control of HbA1c values during pregnancy decreases congenital malformations, large-for-date infants, and the complications of pregnancy and delivery.
“Specifically, stringent control of HbA 1c values during pregnancy decreases congenital malformations, large-for-date infants, and the complications of pregnancy and delivery that can otherwise occur when glycemic control is not carefully managed (333).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [333]
The Initial evaluation section links good glycemic control to fewer oversized infants and maternal, fetal, and neonatal complications. It places the risk of congenital malformations in the first few weeks of pregnancy and recommends achieving near-normal A1C before pregnancy to prevent them. The claim omits that timing distinction, implying that stringent control at any point during pregnancy reduces malformations. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Stringent control of HbA1c during pregnancy decreases the risk of congenital malformations, large-for-date infants, and complications of pregnancy and delivery.
“Specifically, stringent control of HbA 1c values during pregnancy decreases the risk of congenital malformations, large-for-date infants, and the complications of pregnancy and delivery that can otherwise occur when glycemic control is not carefully managed (198).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [198]

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Authors: Kitzmiller, J. L., Block, J. M., Brown, F. M., Catalano, P. M., Conway, D. L., Coustan, D. R., Gunderson, E. P., Herman, W. H., Hoffman, L. D., Inturrisi, M., Jovanovic, L. B., Kjos, S. I., Knopp, R. H., Montoro, M. N., Ogata, E. S., Paramsothy, P., Reader, D. M., Rosenn, B. M., Thomas, A. M., & Kirkman, M. S.
Affiliations: Santa Clara Valley Medical Center (US)
Stanford Medicine (US)
Joslin Diabetes Center (US)
MetroHealth Medical Center (US)
The University of Texas at San Antonio Health Science Center (US)
Brown University (US)
Kaiser Permanente (US)
University of Michigan (US)
Diabetes and Pregnancy Program, Obstetrix Medical Group, San Jose, California
University of California, San Francisco (US)
Sansum Diabetes Research Institute, Santa Barbara, California
University of California, Los Angeles (US)
University of Washington (US)
University of Southern California (US)
Northwestern University (US)
International Diabetes Center, Minneapolis, Minnesota
St. Luke's-Roosevelt Hospital Center (US)
St. Joseph’s University Medical Center (US)
American Diabetes Association (US)
ORCID: Brown, Florence M.
Catalano, Patrick M.
Conway, Deborah L.
Coustan, Donald R.
Gunderson, Erica P.
Herman, William H.
Kirkman, M. Sue
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2008-05-01
Volume: 31
Issue: 5
Pages: 1060-1079
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc08-9020
PMC: PMC2930883
OpenAlex: W2097577333
Semantic Scholar: ea988c5ae6c3954b51ee201b85c230b7d9b63a69
Cited by: 476
References: 197
Citations by year: 2026: 6 · 2025: 12 · 2024: 11 · 2023: 24 · 2022: 25 · 2021: 16 · 2020: 19 · 2019: 21 · 2018: 25 · 2017: 81 · 2016: 29 · 2015: 29 · 2014: 31 · 2013: 28 · 2012: 29
FWCI: 34.14
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (K01DK059944)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: pregestational diabetes, pregnancy, preconception care, glycemic control, family planning, multidisciplinary care, patient-centered care, diabetic nephropathy, diabetic neuropathy, diabetic retinopathy, cardiovascular disease, hypertension, dyslipidemia, depression, thyroid dysfunction, drug safety in pregnancy, statins, ACE inhibitors, angiotensin receptor blockers, postpartum care
MeSH terms: Blood Glucose, Diabetes Mellitus, Female, Humans, Patient Care Planning, Pregnancy, Pregnancy Complications, Pregnancy in Diabetics, Blood Glucose Self-Monitoring, Diabetes Complications

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