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Feature Article

Type 2 diabetes in pregnancy. A multidisciplinary approach to improving outcomes

NAOMI EASTWOOD-WILSHERE, David McIntyre

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Abstract

Type 2 diabetes in pregnancy is becoming more common and is associated with poor maternal, fetal and childhood outcomes. Preconception counselling and a multidisciplinary team approach throughout pregnancy are crucial to improving outcomes.

Key Points

  • The prevalence of type 2 diabetes in pregnancy is increasing, and is associated with adverse pregnancy outcomes.
  • Uptake of preconception counselling is low, and strategies are needed to ensure all women with type 2 diabetes have access to preconception care, as it is associated with improved outcomes.
  • Management of women with type 2 diabetes in pregnancy needs a multidisciplinary approach, including review by a dietitian and diabetes educator.
  • All women with type 2 diabetes should be screened for complications of diabetes early in pregnancy, with further review depending on risk.
  • High-dose folic acid should be given to all women with type 2 diabetes in pregnancy until 12 weeks’ gestation to decrease the risk of neural tube defects. Low-dose aspirin should also be considered, starting before 16 weeks’ gestation, to decrease the risk of preterm pre-eclampsia.

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