Updated Guidelines Emphasize Asking Diabetic Women About Pregnancy Intentions at Every Healthcare Visit

Recent guidelines underscore the importance for healthcare providers to routinely inquire about reproductive goals of women with diabetes during each medical encounter. This proactive approach aims to facilitate proper preconception planning, reducing risks such as miscarriage and birth defects among women managing diabetes before pregnancy.

As part of comprehensive diabetes care, physicians are encouraged to discuss family planning, pregnancy timing, and contraception to ensure women are fully informed and prepared for pregnancy when ready. This initiative responds to the rising prevalence of diabetes in women of reproductive age, which often leads to inadequate preconception care.

The guidelines recommend that clinicians ask all women of childbearing age about their desire to conceive at every visit, whether related to their diabetes management or general health. For pregnant women with diabetes, early delivery—preferably before 39 weeks—is advised if risks associated with continuing pregnancy outweigh those of early birth. Additionally, certain medications like GLP-1 weight-loss drugs should be discontinued prior to conception, and metformin use during pregnancy should be carefully evaluated, especially in women already on insulin.

Innovations in insulin delivery, such as hybrid closed-loop systems with continuous glucose monitoring, are encouraged for pregnant women with type 1 diabetes to optimize glucose control. Furthermore, ongoing family planning and contraception use are critical until women are ready to conceive.

These recommendations are supported by substantial evidence from clinical trials and issued jointly by the Endocrine Society and the European Society of Endocrinology, with backing from leading organizations like the American Diabetes Association and the American College of Obstetricians and Gynecologists. Overall, emphasizing reproductive discussions at every healthcare visit aims to improve pregnancy outcomes and support women with diabetes in their family planning decisions.