Type 1 diabetes mellitus and pregnancy

The care of pregnant women with type 1 diabetes is demanding for the affected women, their social environment, and their caregivers. For the mothers, particularly severe hypoglycemia and pre-eclampsia play a role. The newborns frequently show major malformations, macrosomies, and neonatal hypoglycemia; the risk of intrauterine fetal death is increased. Many risks can be mitigated by preconception counseling and thereby behavioral changes. Of particular importance are optimized periconceptional metabolic control and the intake of folic acid. Treatment with ICT (intensified conventional therapy) or CSII (continuous subcutaneous insulin infusion) should be considered equivalent; insulin analogues can be used according to recent evidence. The importance of new techniques, such as rtCGM (real-time continuous glucose monitoring) is overestimated for the outcome of pregnancy.