Type 1 Diabetes: Management in Women From Preconception to Postpartum

J Clin Endocrinol Metab. 2021 Mar 25;106(4):952-967. doi: 10.1210/clinem/dgaa931.

Abstract

Context: This review presents an up-to-date summary on management of type 1 diabetes mellitus (T1DM) among women of reproductive age and covers the following time periods: preconception, gestation, and postpartum.

Evidence acquisition: A systematic search and review of the literature for randomized controlled trials and other studies evaluating management of T1DM before pregnancy, during pregnancy, and postpartum was performed.

Evidence synthesis: Preconception planning should begin early in the reproductive years for young women with T1DM. Preconception and during pregnancy, it is recommended to have near-normal glucose values to prevent adverse maternal and neonatal outcomes, including fetal demise, congenital anomaly, pre-eclampsia, macrosomia, neonatal respiratory distress, neonatal hyperbilirubinemia, and neonatal hypoglycemia.

Conclusion: Women with T1DM can have healthy, safe pregnancies with preconception planning, optimal glycemic control, and multidisciplinary care.

Keywords: postpartum; preconception; pregestational diabetes; pregnancy; type 1 diabetes mellitus.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / therapy*
  • Female
  • Humans
  • Infant, Newborn
  • Postnatal Care* / methods
  • Postnatal Care* / standards
  • Postpartum Period / physiology
  • Preconception Care* / methods
  • Preconception Care* / standards
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy in Diabetics / epidemiology
  • Pregnancy in Diabetics / therapy*
  • Prenatal Care / methods
  • Prenatal Care / standards
  • Young Adult