Preconception Counseling and Type 2 Diabetes

Slocum, Julie

doi:10.2337/diaspect.20.2.117

Cited by 9 publications

(8 citation statements)

References 35 publications

(36 reference statements)

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“…Research across Australia and internationally has established that there are low rates of preconception care among women with T2DM [3,19,20]. A recent crosssectional survey of healthcare professionals within the NT Diabetes In Pregnancy (DIP) Partnership highlighted that few women with T2DM are seen for preconception counselling [21].…”

Section: Introductionmentioning

confidence: 99%

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

Klein

Boyle

Kirkham

et al. 2017

Diabetes Research and Clinical Practice

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Section: Introductionmentioning

confidence: 99%

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

Klein

Boyle

Kirkham

et al. 2017

Diabetes Research and Clinical Practice

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“…11,21 The discrepancy in GPs' and secondary healthcare professionals' views regarding the magnitude of the problem may be explained by the current low case load per GP practice and a prevalent misperception that type 2 diabetes is more benign and only affects older women. 5 However, the changing patient profile and rising numbers of pregnant women with type 2 diabetes underline the urgency of integrating preconception care into primary care systems. To this end, there is a need for better integration and division of resources between primary and secondary care.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…The suggestion by some GPs that preconception care should be offered routinely is supported by other study findings. 5,17 Some authors specify the need for diabetes preconception care to start from puberty, 5,21 while others suggest that all health professionals should consider every visit with women of childbearing age to be a preconception visit.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…The prevalence of type 1 diabetes mellitus and type 2 diabetes mellitus in pregnancy is rising nationally and internationally, [1][2][3][4][5] and is associated with increased risks of adverse pregnancy outcomes. 2,4,[6][7][8][9][10][11][12] Preconception care for women with diabetes is an effective means to reduce the incidence of adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…2,4,[6][7][8][9][10][11][12] Preconception care for women with diabetes is an effective means to reduce the incidence of adverse pregnancy outcomes. 10,[13][14][15] However, to date, the majority of women with diabetes enter pregnancy poorly prepared, 1,5,6,11,13 and the provision of diabetes preconception care continues to be patchy across the UK. 14 Historically, in the UK, diabetes care has been provided in the specialist hospital setting.…”

Section: Introductionmentioning

confidence: 99%

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Integrating preconception care for women with diabetes into primary care: a qualitative study

Mortagy¹,

Kielmann

Baldeweg

et al. 2010

Br J Gen Pract

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BackgroundNational guidelines emphasise the need to deliver preconception care to women of childbearing age. However, uptake of the services among women with diabetes in the UK is low. Questions arising include how best to deliver preconception care and what the respective roles of primary versus secondary caregivers might be. AimTo explore the perspective of GPs and secondary care health professionals on the role of GPs in delivering preconception care to women with diabetes. Design of studyQualitative, cross-sectional study. SettingA London teaching hospital and GP practices in the hospital catchment area. MethodSemi-structured interviews with GPs and members of the preconception care team in secondary care. Thematic analysis using the framework approach. ResultsGPs and secondary care professionals differ in their perception of the number of women with diabetes requiring preconception care and the extent to which preconception care should be integrated into GPs' roles. Health professionals agreed that GPs have a significant role to play and that delivery of preconception care is best shared between primary and secondary care. However, the lack of clear guidelines and shared protocols detailing the GP's role presents a challenge to implementing 'shared' preconception care. ConclusionGPs should be more effectively involved in providing preconception care to women with diabetes. Organisational and policy developments are required to support GPs in playing a role in preconception care. This study's findings stress the importance of providing an integrated approach to ensure continuity of care and optimal pregnancy preparation for women with diabetes.

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Fecundability among women with type 1 and type 2 diabetes in the Norwegian Mother and Child Cohort Study

et al. 2010

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Aims/Hypothesis We assessed the effects of type 1 diabetes and type 2 diabetes on fecundability (as manifest by increased time-to-pregnancy (TTP)) in a large cohort of pregnant women. Methods This study is based on the Norwegian Mother and Child Cohort Study (MoBa). Members of this large cohort were enrolled early in pregnancy and asked about TTP and other factors. Among the 58,004 women included in the analysis, we identified 221 cases of type 1 diabetes and 88 cases of type 2 diabetes using the Medical Birth Registry of Norway. A logistic analog of the proportional probability model, a Cox-like discrete-time model, was used to compute fecundability odds ratios (FOR) and 95% CI for type 1 diabetes and type 2 diabetes, adjusted for maternal age and prepregnancy BMI. Results Compared with non-diabetic women, the adjusted FOR for women with type 1 diabetes was 0.76 (95% CI=0.64, 0.89) and the adjusted FOR for women with type 2 diabetes was 0.64 (95% CI=0.48, 0.84). These FORs did not change substantively and remained statistically significant after excluding women with irregular menstrual cycles and accounting for cycle length. Conclusions/Interpretation The results from the present study provide evidence of substantially decreased fecundability for women with type 1 and type 2 diabetes, even among those with normal menstrual cycles.

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Preconception Counseling and Type 2 Diabetes

Cited by 9 publications

References 35 publications

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

Integrating preconception care for women with diabetes into primary care: a qualitative study

Fecundability among women with type 1 and type 2 diabetes in the Norwegian Mother and Child Cohort Study

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