Preexisting diabetes: Expert consensus from the College of French Gynecologists and Obstetricians and from the French Society of Diabetology
Abstract
In France, 0.2% of women who gave birth in 2021 had type 1 diabetes, and 0.3% had type 2 diabetes. Regarding preconception care, it is recommended that women with any type of diabetes achieve an HbA1c level of less than 6.5%. For women using continuous glucose monitoring (CGM), the recommended target range is 0.70-1.80g/L (3.9-10mmol/L), and it is recommended to achieve this range at least 70% of the time. The preconception assessment includes: 1) an HbA1c measurement, 2) an assessment of microangiopathic impact, 3) an assessment of macroangiopathic complications, 4) screening for associated cardiovascular risk factors, and 5) a TSH measurement in women with type 1 diabetes (T1D), as well as screening for obstructive sleep apnea syndrome during questioning in cases of type 2 diabetes (T2D) and obesity in women with T1D. To improve preconception glycemic control, implementation of a CGM system is recommended for all women with T1D. Implementation of automated insulin delivery (AID) in anticipation of pregnancy should also be discussed as part of a shared medical decision. For type 2 diabetes, treatment with metformin and/or insulin therapy is recommended if necessary. Other antidiabetic treatments should be discontinued before conception. The following is recommended: 1) Discontinuing statin and potentially teratogenic antihypertensive treatments, replacing them with treatments compatible with pregnancy; 2) systematically providing smoking cessation advice to women who smoke,…
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.