Experts Emphasize the Importance of Routine Screening for Women with Diabetes Planning Pregnancy

A recent joint guideline issued by the Endocrine Society and the European Society of Endocrinology (ESE) underscores the critical need for proactive preconception care among women with diabetes. The guideline advocates for healthcare providers to routinely inquire about reproductive intentions during every visit—be it reproductive, diabetes, or primary care appointments—to ensure timely intervention and optimal pregnancy outcomes.

Women with pre-existing diabetes are at a heightened risk of adverse pregnancy outcomes, including miscarriages and birth defects, primarily driven by modifiable factors such as blood sugar control and body mass index (BMI). The guidelines recommend integrating advanced diabetes management technologies and therapeutics before, during, and after pregnancy to improve maternal and neonatal health.

Key recommendations include screening all women of reproductive age with diabetes about their pregnancy plans, timing of delivery—preferably before 39 weeks to mitigate pregnancy-related risks—discontinuing certain medications like GLP-1 receptor agonists prior to conception, and cautious use of medications such as metformin in pregnant women with insulin-dependent diabetes. The use of hybrid closed-loop insulin systems is encouraged for pregnant women with type 1 diabetes to maintain tight glycemic control.

Contraception is also emphasized for women with diabetes who are not yet ready to conceive, helping to plan pregnancies around optimal health conditions. The guidelines highlight the importance of ongoing research, especially in establishing glycemic targets during pregnancy, nutrition, and obesity management, to further improve maternal-fetal health outcomes.

Developed using a rigorous evidence-based approach and reviewing data from randomized controlled trials, these guidelines aim to raise awareness and standardize care regarding reproductive health in women with diabetes. Dr. Jennifer Wyckoff, chair of the guideline development team, remarked on the rising prevalence of diabetes among women of reproductive age and the urgent need for comprehensive preconception strategies.

In summary, routine screening for reproductive intentions in women with diabetes can significantly reduce pregnancy complications and support healthier pregnancies, aligning care with modern advances in diabetes technology and therapeutics.