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Pre-existing diabetes in pregnancy — SCE Endocrinology MCQ

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ModerateDiabetesPre-existing diabetes in pregnancySCE Endocrinology

A 34-year-old woman with type 1 diabetes is planning pregnancy. HbA1c is 67 mmol/mol and she takes atorvastatin and ramipril for microalbuminuria. She has background retinopathy. What is the most appropriate pre-conception advice?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Optimise HbA1c and stop teratogenic cardiometabolic medicines before conception

Pre-conception care should optimise glycaemia and review medicines such as statins and ACE inhibitors before pregnancy. Waiting until a positive test exposes the embryo to avoidable teratogens. Retinopathy should be assessed before and during pregnancy because rapid glycaemic improvement can worsen it.

Reference: NICE NG3; NICE NG17; BNF