Prepregnancy care and the prevention of fetal malformations in the pregnancy complicated by diabetes.

The offspring of women with diabetes have an increased incidence of congenital malformations as compared with the general population. There is strong evidence in both humans and animal studies, demonstrating an association between these malformations and poor glycemic control in the periconceptual period. Furthermore, clinical trials have demonstrated that strict glucose control can reduce the rate of these malformations to the background rate. Therefore, it is recommended that all women with diabetes of childbearing age be advised of the importance of seeking preconception care, which includes attainment of optimal glucose control and the use of contraception.