Balance risk with reality for pre-conception diabetic counseling



There is no “safe” lower glycemic threshold for pregnant women with diabetes below which adverse maternal and fetal/neonatal outcomes aren’t seen. In particular, “several retrospective studies have shown that the risk for congenital malformations is increased with higher hemoglobin A1c levels,” said Susan Kirk, MD, speaking at a “Meet the Professor” session at the annual meeting of the Endocrine Society.

However, pointed out Dr. Kirk, fact-based counseling about pregnancy risks for women with type 1 or type 2 diabetes can – and should – occur within the framework of a strong and accepting physician-patient relationship.

Most women with diabetes have received pre-conception counseling about the risks of pregnancy with diabetes and the importance of glycemic control. “Despite that, I think many of us are often surprised by the percentage of unplanned pregnancies,” said Dr. Kirk, of the University of Virginia, Charlottesville, in an interview.

“What I have learned is that the desire to become pregnant is so strong, and the contemplation of all the adverse events that can happen … is really scary, not only to the woman but to her partner as well.”

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel.

Next Article:

   Comments ()