A 34-year-old woman with type 1 diabetes is planning pregnancy. HbA1c is 67 mmol/mol and she has background retinopathy. She takes insulin degludec,

Question

A 34-year-old woman with type 1 diabetes is planning pregnancy. HbA1c is 67 mmol/mol and she has background retinopathy. She takes insulin degludec, folic acid 400 micrograms and atorvastatin. Blood pressure is 118/72 mmHg. What is the most appropriate management?

Accepted Answer

Optimise HbA1c and replace atorvastatin before conception

Answer

Start gliclazide to reduce insulin dose

Answer

Stop insulin until pregnancy is confirmed

Answer

Start ACE inhibitor for retinopathy prevention

Answer

Proceed to pregnancy with current medicines

Pre-existing type 1 diabetes and preconception care — SCE Endocrinology MCQ

A 34-year-old woman with type 1 diabetes is planning pregnancy. HbA1c is 67 mmol/mol and she has background retinopathy. She takes insulin degludec, folic acid 400 micrograms and atorvastatin. Blood pressure is 118/72 mmHg. What is the most appropriate management?