Chronic Medical Conditions: Diabetes

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Selection of Appropriate Medication

Insulin is recommended for both Type I and II DM, since other agents (for lack of data) have not been demonstrated as safe for use during early pregnancy (Although, many doctors use them anyway because they believe their benefit outweighs any potential risk.).

The ADA recommends against the use of ACE inhibitors, beta blockers, and diuretics in women attempting pregnancy.

 

What if a woman cannot achieve low-risk HbA1C levels?

 

Women who cannot achieve low-risk HbA1C levels (<1% above normal) during the preconception period should be offered contraception and advised not to become pregnant until they can achieve optimal glycemic control. Because consequences are so potentially grave if contraception unexpectedly fails, emphasis should be on employing the most effective method of contraception for those women not attempting a pregnancy.