Diabetes and Pregnancy

Full Guideline: Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline
JCEM November 2013

Ian Blumer, Eran Hadar, David R. Hadden, Lois Jovanovič, Jorge H. Mestman, M. Hassan Murad, Yariv Yogev

Objective:

Our objective was to formulate a clinical practice guideline for the management of the pregnant woman with diabetes.

Background:

In recent years, important new research has emerged in the field of diabetes and pregnancy. This guideline has been developed to address and distill this burgeoning literature with the goal of assisting healthcare providers to best manage their pregnant patients living with overt or gestational diabetes using contemporary, evidence-based strategies.

In this guideline, all references to diabetes specifically and exclusively refer to diabetes mellitus. Also, unless stated otherwise, the terms diabetes, overt diabetes, and pregestational diabetes refer to either type 1 or type 2 diabetes.

We use the traditional term gestational diabetes to describe what has customarily been defined as “any degree of glucose intolerance with onset or first definition during pregnancy” while acknowledging that the more contemporary term hyperglycemia in pregnancy has strong merit as a more appropriate term. We have retained the longstanding term (gestational diabetes) owing to its widespread familiarity and traditional usage.

Select thyroid recommendations in this Diabetes and Pregnancy Guideline are included as they relate specifically to thyroid disease in pregnant women with diabetes. See the 2012 Endocrine Society Clinical Practice Guideline on pregnancy and thyroid disease for a detailed discussion on this topic.

This guideline advocates for use of best practices based on an analysis of the contemporary (and older) medical literature. It is, however, recognized that cost considerations and other practical realities may not necessarily allow for implementation of certain of our recommendations in some locales.

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