Diabetes and Pregnancy Robbie Lindsay BHF Glasgow Cardiovascular Research Centre

Per annum 15,000 deliveries 67 women with T1DM 53 T2DM (0.8% of deliveries in 2015) ~2500 OGTT’s per annum

Pregnancy in women with T1DM and T2DM are high risk

Pregnancy in women with T1DM and T2DM is high risk

Pre pregnancy planning in type 1 and type 2 diabetes folic acid HbA1c control at risk medications statins ACE ARB complications Bell et al Diabetologia

Can we help women prepare for pregnancy better?

General obstetric population in GG&C 24% of women BMI>30 at booking 0.8% BMI over 45 10.6% Family history diabetes 1.2% previous GDM 13.3% at risk ethnicity

Follow up Mothers Age 43.6 years 10.7% T2DM vs 1.6% 41.5% IFG or IGT vs 18.4% Mothers with Fasting ≥5.1 OR 1 hour ≥10.0 OR =14.3% 2 hour ≥8.5 mmol/l BMI 29.7 age 31.9 years fasting 4.9 1h 9.6 2 hour 7.7 mmol/l Follow up Children Age 11.5 years Obese 19.1% vs 9.9 % Overweight 20.4 vs 18.7% IGT 10.6% vs 5.0%

Better counselling before pregnancy Better detection GDM in pregnancy Better prevention T2DM after pregnancy