PHILADELPHIA — No matter the reason a woman of reproductive age with diabetes goes to see a medical professional, her diabetes must be part of the discussion, according to a presenter here at the annual meeting of the American Association of Nurse Practitioners.
“Preconception care should be an element of care for every visit, with every woman [with diabetes] that is of reproductive age that is seen in a clinic regardless of reason for the visit,” Jacqueline LaManna, PhD, ANP-BC, BC-ADM, CDE, that practices and teaches in central Florida told Healio Family Medicine in an interview.
“It is not currently,” she added. “When providers are seeing these young women, they should be assessing potential for pregnancy and counseling these women relative to risk and helping them control their blood sugar.”
These discussions should be given special consideration, just as the conversations about folic acid, immunization status, emotional wellness and smoking cessation in women of reproductive age are, LaManna said.
She wrote in her poster that preconception care may reduce anomaly risk in diabetes care by 75%. Potential consequences of perinatal hyperglycemia in the mother are preeclampsia, cardiovascular events and surgical delivery. Possible risks to the infant include stillbirth, congenital abnormalities and respiratory distress, according to LaManna.
“A lot of pregnancies are getting confirmed in primary care,” she said. “But not all primary care physicians are comfortable working with a woman who is pregnant and has diabetes ... so they tell the patient to go see their obstetrical provider and potentially their endocrinologist. However, there can sometimes be delays [in seeing these medical professionals], and these delays are happening at the time that the baby is forming. It’s very important that primary care doctors be comfortable discussing diabetes with these patients.” – by Janel Miller
LaManna, J. “What to do before one becomes two: Preconception care in women with diabetes.” Presented at: American Association of Nurse Practitioners National Conference; Jun. 20-25, 2017; Philadelphia.
Disclosure: Healio Family Medicine was unable to confirm relevant financial disclosures prior to publication.