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Gestational Diabetes Care Guidelines

Pre-Existing Diabetes Mellitus

  • It is beyond the scope of this document to cover management of pre-existing type 1 or type 2 Diabetes Mellitus during pregnancy.
  • Because patients with a history of GDM are at risk of developing type 2 DM, the following points emphasize the importance of appropriate postpartum counseling and follow-up after a GDM pregnancy.
    • Preconception euglycemia decreases the risk of both miscarriage and congenital anomalies in patients with DM to levels equal to that of normal patients. Therefore documentation of euglycemia by hemoglobin A1C and/or home monitoring in the 3 to 6 months prior to conceptionis recommended.
    • Diabetes and its co-existing medical complications may result in adverse maternal medical and obstetrical outcomes. Therefore, all women with diabetes should have preconception counseling which addresses both obstetrical and medical considerations.

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