The Endocrine Society and the European Society of Endocrinology released new joint guidelines emphasizing the need for proper preconception care for women with diabetes. The guidelines recommend that women with diabetes receive care and access to new diabetes treatments before, during, and after pregnancy to reduce health risks.
Screening at Every Visit to Improve Outcomes
The guidelines stress the importance of screening women of reproductive age for pregnancy intentions at every healthcare visit — whether it’s a reproductive, diabetes, or primary care appointment. This approach helps identify women planning to conceive and allows timely preconception care. Proper care can lower the chances of pregnancy complications linked to factors like high blood sugar.
Dr. Jennifer Wyckoff, chair of the guideline committee from the University of Michigan, said, “Diabetes rates are rising among women of childbearing age, yet few receive appropriate preconception care. These guidelines also cover advances in diabetes technology, timing of delivery, medications, and diet.”
Preventing Miscarriages and Birth Defects
The guidelines highlight how proper management can help prevent adverse outcomes such as miscarriages and birth defects. They were published in The Journal of Clinical Endocrinology & Metabolism and the European Journal of Endocrinology and presented at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco.
A multidisciplinary panel of experts developed the recommendations based on evidence reviews. The process was funded by the societies themselves, without corporate sponsorship.
Key Recommendations on Screening and Care
Women should be asked about their pregnancy plans during every healthcare visit. This allows doctors to offer counseling and screening to manage risks for those wanting to conceive. Those not planning pregnancy should receive guidance on contraceptive options.
The guidelines note that risks like birth defects occur early, even before pregnancy is confirmed, making preconception care essential for improving women’s health.
Timing of Delivery and Diabetes Management
Delivery timing should balance risks to both mother and baby. For women with diabetes, delivering at 39 weeks or later might carry more risks than delivering slightly earlier.
New diabetes technologies, like hybrid closed loop insulin systems, are recommended for pregnant women with type 1 diabetes. Women taking insulin should stop using GLP-1 anti-obesity drugs before pregnancy and switch to metformin during this time.
Since contraception use is lower among women with diabetes, the guidelines recommend personalized counseling to support shared decision-making about birth control until women are ready to get pregnant.
Calls for More Research
The guidelines also emphasize the need for more research into preconception care, including studies to define optimal blood sugar targets during pregnancy and the best nutrition and obesity treatments.
Dr. Wyckoff added, “Investing in research on preconception care and pregnancy management will help improve outcomes for mothers and babies.”
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