EVEN BEFORE the conclusion of the Diabetes Control and Complications Trial in 1993,1 data were available supporting the importance of optimal glycemic control during pregnancy in women with diabetes. The factors that influence women to seek preconception care and counseling and then to actually achieve optimal glycemic control prior to conception have become important to us as clinicians.
The factors that seem to promote preconception care for women with diabetes include higher educational levels, higher incomes, regular employment, and receiving encouragement from their health care providers to avoid unplanned pregnancies.2 In their study, Casele and Laifer3 address a slightly different issue: those factors that actually affect preconception glycemic control.
The identification of factors affecting preconception glycemic control is an important issue in diabetes care and is relevant to general internists. It is estimated that up to 90% of patients with type 1 diabetes and 95% of those with type 2 . . . [Full Text of this Article]