Background
In recent years, diabetes among women of reproductive age has become an increasingly pressing health concern. The condition not only affects women’s overall well-being but also poses significant risks during pregnancy, potentially impacting both maternal and fetal health. Recognizing the urgency of addressing these challenges, the Endocrine Society and the European Society of Endocrinology have jointly released new clinical guidelines focusing on preconception care for women with diabetes. These recommendations aim to guide healthcare professionals and empower patients in navigating diabetes management before, during, and after pregnancy.
Scientific and Clinical Evidence: What the Data Tell Us
Research has consistently shown that unmanaged diabetes during pregnancy can lead to adverse outcomes, including congenital anomalies, miscarriage, and preterm birth. Elevated blood glucose levels during early pregnancy are particularly concerning, as they can interfere with embryonic development. Studies indicate that maintaining optimal glycemic control before conception significantly reduces these risks, underscoring the importance of preconception care.
The guidelines recommend screening women with diabetes for their intent to conceive during every reproductive, diabetes, and primary care visit. This proactive approach allows healthcare providers to identify patients who may benefit from preconception counseling and intervention. For example, women with poorly controlled diabetes can be guided in achieving better glycemic control, optimizing their health before attempting pregnancy.
Misconceptions and Harmful Behaviors
Despite the clear evidence supporting preconception care, misconceptions about diabetes and pregnancy persist. One common myth is that pregnancy is unmanageable for women with diabetes. While this is untrue, it highlights the need for accurate education and support. Additionally, some women may delay seeking medical advice due to fear or lack of awareness about potential risks. Addressing these concerns through patient education and community outreach is vital.
Another factor is the underutilization of contraception among women with diabetes who are not planning a pregnancy. Currently, the prevalence of contraceptive use in this population is lower than average, resulting in unintended pregnancies that occur without adequate preparation or management of diabetes. The guidelines stress the importance of patient-centered contraceptive counseling to mitigate these risks.
Correct Health Practices and Practical Recommendations
The new guidelines advocate several key practices for managing diabetes in women of reproductive age:
1. **Preconception Planning:** Women should work closely with their healthcare providers to establish glycemic targets and optimize their health before conception. This includes medication adjustments, dietary interventions, and lifestyle changes.
2. **Screening for Pregnancy Intent:** Tools like the “One Key Question” approach—asking patients if they plan to conceive—help tailor care to their needs.
3. **Diabetes Technology:** Advanced management systems, such as hybrid closed-loop systems, are recommended for pregnant women with type 1 diabetes to maintain stable blood sugar levels.
4. **Delivery Timing:** For women with diabetes, delivery before 39 weeks’ gestation may be preferable to reduce risks associated with prolonged pregnancy.
5. **Contraceptive Counseling:** Until pregnancy is planned, contraceptive options should be discussed to ensure patient-centered care and shared decision-making.
Expert Insights and Commentary
Dr. Jennifer Wyckoff, chair of the guideline development panel, emphasizes the impact of rising diabetes rates among women of reproductive age. “The guidelines aim to address gaps in preconception care, leveraging advances in diabetes technology and emphasizing patient-centered approaches,” she states. The focus on preventing adverse pregnancy outcomes highlights the importance of investment in research and healthcare infrastructure.
Conclusion
The joint guidelines from the Endocrine Society and European Society of Endocrinology represent a crucial step forward in improving maternal and neonatal outcomes for women with diabetes. By prioritizing preconception care, healthcare providers can help reduce complications and improve quality of life for patients and their families. These recommendations serve as a call to action for clinicians, researchers, and policymakers to support women in achieving healthy pregnancies and managing diabetes effectively.
References
1. Experts suggest screening women with diabetes for intent to conceive at every doctor visit. The Endocrine Society. July 13, 2025. Accessed July 14, 2025. https://www.eurekalert.org/news-releases/1090818.
2. Wyckoff JA, Lapolla A, Asias-Dinh BD, et al. Preexisting diabetes and pregnancy: An Endocrine Society and European Society of Endocrinology joint clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2025. doi:10.1210/clinem/dgaf288.
