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Proliferative diabetic retinopathy in preconception care — SCE Endocrinology MCQ

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HardDiabetesProliferative diabetic retinopathy in preconception careSCE Endocrinology

A 47-year-old woman with type 1 diabetes is planning pregnancy. Retinal screening shows proliferative diabetic retinopathy with new vessels at the disc. HbA1c has improved rapidly from 88 to 54 mmol/mol over 3 months. What is the most appropriate management?

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

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Correct answer: D — Urgent ophthalmology treatment before conception

Proliferative retinopathy should be treated and stabilised before pregnancy where possible, because pregnancy and rapid glycaemic improvement can worsen retinopathy. Proceeding without ophthalmology input risks sight-threatening progression. The pearl is that preconception diabetes optimisation includes retinal safety.

Reference: NICE NG3, Royal College of Ophthalmologists diabetic retinopathy guidance