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Feature Article

Diabetes mellitus and pregnancy: the GP’s role

N Wah Cheung, Aidan McElduff

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Abstract

The outcomes of pregnancy in the many young women with pregestational diabetes who are not under the regular care of specialist physicians can be optimised by GPs taking an active role in preconception counselling and ensuring good glycaemic control is established well before conception.

Key Points

  • Pregnancy outcomes in patients with diabetes can be optimised by appropriate care. Preconception counselling and meticulous glycaemic control before and during pregnancy are essential.
  • Patients need assessment for the presence of micro- and macrovascular complications of diabetes. Some of these need therapy before pregnancy (e.g. retinopathy) while others increase the likelihood of problems in pregnancy (e.g. autonomic neuropathy or nephropathy) or place the mother’s health at increased risk (e.g. macrovascular disease).
  • Postpartum counselling and adjustment of insulin therapy is required to ensure patient safety.
  • Drug therapy, including complementary therapy, should be reviewed.

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