Diabetes and Pregnancy Diabetes Canada Clinical Practice Guidelines Expert Committee

• All women with pre-existing type 1 or type 2 diabetes should receive preconception care to optimize glycemic control, assess for complications, review medications and begin folic acid supplementation. • Effective contraception should be provided until the woman is ready for pregnancy. • Care by an interprofessional diabetes health-care team composed of a diabetes nurse educator, dietitian, obstetrician and endocrinologist/internist with expertise in diabetes, both prior to conception and during pregnancy, has been shown to minimize maternal and fetal risks in women with pre-existing type 1 and type 2 diabetes. • Women should aim for a glycated hemoglobin (A1C) of ≤7.0% (ideally ≤6.5% if possible) when planning pregnancy, or ≤6.5% (ideally ≤6.1% if possible) during pregnancy. • Women should consider the use of the continuous glucose monitor during pregnancy to improve glycemic control and neonatal outcomes.