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Consensus statement on diabetes control in preparation for pregnancy

H David McIntyre and Jeff R Flack, on behalf of the National Diabetes in Pregnancy Advisory Committee
Med J Aust 2004; 181 (6): 326.

The National Diabetes in Pregnancy Advisory Committee (NDIPAC) is a multidisciplinary committee established in November 2000 by the Commonwealth Department of Health and Aged Care as part of the National Diabetes Strategy. On behalf of the NDIPAC, we present the first Australian consensus statement (endorsed by the Committee in February 2004) on diabetes control for women with type 1 or type 2 diabetes who are preparing for pregnancy:

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  • H David McIntyre1
  • Jeff R Flack2
  • on behalf of the National Diabetes in Pregnancy Advisory Committee

  • 1 Department of Endocrinology, Mater Health Services, South Brisbane, QLD.
  • 2 Diabetes Centre, Bankstown–Lidcombe Hospital, Bankstown, NSW.

Correspondence: 

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  • 2. Gabbe SG, Mestman JH, Freeman RK, et al. Management and outcome of pregnancy in diabetes mellitus, classes B to R. Am J Obstet Gynecol 1977; 129: 723-732.
  • 3. Miller E, Hare JW, Cloherty JP, et al. Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers. N Engl J Med 1981; 304: 1331-1334.
  • 4. Fuhrmann K, Reiher H, Semmler K, et al. Prevention of congenital malformations in infants of insulin-dependent diabetic mothers. Diabetes Care 1983; 6: 219-223.
  • 5. Greene MF, Hare JW, Cloherty JP, et al. First-trimester hemoglobin A1 and risk for major malformation and spontaneous abortion in diabetic pregnancy. Teratology 1989; 39: 225-231.
  • 6. The Diabetes Control and Complications Trial Research Group. Pregnancy outcomes in the Diabetes Control and Complications Trial. Am J Obstet Gynecol 1996; 174: 1343-1353.
  • 7. Hanson U, Persson B, Thunell S. Relationship between haemoglobin A1c in early type 1 (insulin-dependent) diabetic pregnancy and the occurrence of spontaneous abortion and fetal malformation in Sweden. Diabetologia 1990; 33: 100-104.
  • 8. Sheffield JS, Butler-Koster EL, Casey BM, et al. Maternal diabetes and infant malformations. Obstet Gynecol 2002; 100: 925-930.
  • 9. Hawthorne G, Robson S, Ryall EA, et al. Prospective population based survey of outcomes of pregnancy in diabetic women: results of the Northern Diabetic Pregnancy Audit, 1994. BMJ 1997; 315: 279-291.
  • 10. Casson IF, Clarke CA, Howard CV, et al. Outcomes of pregnancy in insulin dependent diabetic women: results of a five year population cohort study. BMJ 1997; 315: 275-278.
  • 11. Fenig DS, Palda VA. Type 2 diabetes in pregnancy: a growing concern. Lancet 2002; 359: 1690-1692.
  • 12. Suhonen L, Hiilesmaa V, Teramo K. Glycaemic control during early pregnancy and fetal malformations in women with type 1 diabetes mellitus. Diabetologia 2000; 43: 79-82.
  • 13. Towner D, Kjos SL, Leung B, et al. Congenital malformations in pregnancies complicated by NIDDM. Diabetes Care 1995; 18: 1446-1451.
  • 14. Ray JG, O’Brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM 2001; 94: 435-444.
  • 15. Gunton JE, McElduff A, Sulway M, et al. Outcome of pregnancies complicated by pre-gestational diabetes mellitus. Aust N Z J Obstet Gynaecol 2000; 40: 38-43.

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