Improving Outcomes in Pregnant Women With Type 1 Diabetes
- Moshe Hod, MD1 and
- Lois Jovanovic, MD2
- 1Perinatal Division, Helen Schneider Hospital for Women, Tel Aviv University, Petah-Tiqva, Israel
- 2Sansum Diabetes Research Institute, Santa Barbara, California
- Address correspondence to Prof. Moshe Hod, Perinatal Division, Helen Schneider Hospital for Women, Tel Aviv University, Petah-Tiqva, 49100, Israel. E-mail: mhod{at}clalit.org.il
Despite the good intentions of the St. Vincent Declaration to reduce adverse outcomes down to that seen in nondiabetic pregnant women, maternal and perinatal adverse outcomes continue to be associated with type 1 diabetes. Optimized glycemia has been shown to be the best management for pregnant type 1 diabetic women (1). It is recognized that high A1C levels are associated with adverse outcomes. Indeed, glycemic control early in pregnancy appears to be critical in the prevention of congenital abnormalities in offspring of type 1 diabetic women (2). Therefore, strict targets of normal A1C are recommended for women planning pregnancy (3). Meeting this strict target A1C is undeniably challenging …
