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Pregestational diabetes: Preconception counseling, evaluation, and management

Emma B Morton-Eggleston, MD, MPH
Ellen W Seely, MD
Section Editors
David M Nathan, MD
Michael F Greene, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


The terms pregestational and preexisting diabetes refer to type 1 or type 2 diabetes mellitus diagnosed prior to a woman's pregnancy. This topic will describe the potential maternal and fetal complications associated with pregnancy in women with preexisting diabetes and discuss preconception risk counseling, evaluation, and management of these women. Other issues related to pregestational diabetes and pregnancy are reviewed separately.

(See "Pregestational diabetes mellitus: Glycemic control during pregnancy".)

(See "Pregestational and gestational diabetes: Intrapartum and postpartum glycemic control".)

(See "Pregestational diabetes mellitus: Obstetrical issues and management".)


The prevalence of diabetes in women of reproductive age is increasing [1,2] and, with it, the proportion of pregnancies complicated by preexisting (rather than gestational) diabetes. Data from clinical cohorts and hospital discharges suggest that pregestational diabetes complicates 1 to 2 percent of all pregnancies and accounts for 13 to 21 percent of diabetes in pregnancy, with the remainder due to gestational diabetes [3-5]. The proportion of pregnant patients with type 1 and type 2 diabetes reflects their prevalence in the specific population. In reproductive-aged women, type 2 diabetes is becoming more prevalent and is more common than type 1 diabetes in some populations [6-8].

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Literature review current through: Nov 2017. | This topic last updated: Dec 12, 2017.
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