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Preconception care in type 1 diabetes — USMLE Step 3 MCQ

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EasyInternal Medicine (chronic management)Preconception care in type 1 diabetesUSMLE Step 3

A 24-year-old woman with type 1 diabetes comes for routine follow-up. A1c is 6.8%. She has no retinopathy and no kidney disease. She is planning pregnancy in 6 months. Which of the following is the most appropriate at this time?

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Correct answer: D — Refer for preconception counseling and optimize glycemic targets

Preconception counseling in diabetes includes optimizing glycemia, medication review, folic acid, retinal and renal assessment, and planning safe pregnancy management. ACE inhibitors are avoided when pregnancy is planned.

Reference: American Diabetes Association Standards of Care in Diabetes 2026