Preconception counseling is essential for all women with preexisting diabetes in their childbearing years. Women with type 1 diabetes or type 2 diabetes should delay pregnancy until their glycosylated hemoglobin levels are <1% above the normal range prior to conception to decrease the risk of adverse perinatal outcomes . Preconceptional care includes a complete physical examination to identify and treat any preexisting diabetes-related or other medical condition, an assessment of her nutritional status, and self-management education, including psychosocial assessment. A discussion of finances is also important because of the additional expense of more frequent testing or diabetes supplies.
Although all women with preexisting diabetes should receive preconceptional counseling, this often does not occur. Recent studies have shown that women with type 2 diabetes are not referred as frequently for preconceptional counseling as their type 1 diabetes counterparts [35, 53-56]. McElduff et al. found that only 12% of women with type 2 diabetes received preconceptional care compared with 27.8% of women with type 2 diabetes . In another study, women with type 2 diabetes had a higher incidence of poor perinatal outcome, including fetal demise, congenital anomalies, and difficult deliveries than women with type 1 diabetes . One reason for this higher prevalence of complications is the misconception that type 2 diabetes is not as severe a condition as type 1 diabetes. This myth must be dispelled and strategies developed, including intensive diabetes self-management, to improve outcomes.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...