New Guidelines Recommend Regular Screening for Women with Diabetes Planning Pregnancy

Recent guidelines issued by the Endocrine Society and the European Society of Endocrinology emphasize the importance of screening women with diabetes for their intention to conceive at every healthcare visit. This initiative aims to improve preconception care and address the rising rates of diabetes among women of reproductive age.

Women with pre-existing diabetes face increased risks of adverse pregnancy outcomes, including miscarriages and congenital anomalies. These risks are often linked to factors such as elevated blood sugar levels and body mass index (BMI). To mitigate these health risks, the new guidelines advocate for routine inquiries about pregnancy intentions during reproductive, diabetes, and primary care check-ups.

The joint clinical practice guideline titled "Diabetes and Pregnancy" was published in The Journal of Clinical Endocrinology & Metabolism and the European Journal of Endocrinology, and it was presented at the recent ENDO 2025 conference. The guidelines were developed in response to a pressing need, as many women with diabetes do not receive adequate preconception care.

Dr. Jennifer Wyckoff, the chair of the guideline committee, highlighted the necessity of addressing preconception care, stating that the guidelines also cover advancements in diabetes management technology, medication protocols, and dietary recommendations.

The key recommendations include:

• Routine Screening: Healthcare providers should inquire about the pregnancy intentions of all women with diabetes at every visit.
• Delivery Considerations: For pregnant women with diabetes, delivery should be planned before 39 weeks, as the risks of continuing pregnancy may surpass those of early delivery.
• Medication Management: It is advised to discontinue anti-obesity medications known as GLP-1 receptor agonists before pregnancy and to refrain from prescribing metformin to those already on insulin.
• Diabetes Technology: The use of hybrid closed-loop systems is recommended for pregnant women with type 1 diabetes.
• Contraceptive Guidance: Women with diabetes should consider using contraception until they are ready to conceive.

Dr. Annunziata Lapolla, co-chair of the guideline committee, emphasized the need for further research and investment in preconception care. The guidelines stress the importance of randomized controlled trials to determine optimal glycemic targets during pregnancy, along with data on nutrition and obesity management.

The Clinical Practice Guideline Program is committed to providing evidence-based recommendations for endocrinologists and other healthcare professionals involved in the management of endocrine-related conditions. Each guideline is developed through a rigorous process by a multidisciplinary panel of experts.