title: [Medical treatment of diabetic patients in high risk pregnancy clinic improves glycemic control prior to fertility treatment].
abstract: BACKGROUND
  Diabetic women are at increased risk for spontaneous abortions and congenital anomalies. Preconception care can improve pregnancy outcome.
  
  
  OBJECTIVE
  To evaluate glycemic control in diabetic women undergoing fertility treatment, and compare between women who were treated in high risk pregnancy (HRP) clinics prior to fertility treatment and those who received usuaL care.
  
  
  METHODS
  Retrospective study on diabetic women undergoing fertility treatment during 2008-2009 in Haifa and Western Galilee District of Clalit Health Services (CHS). Data on fertility treatments, prescription fillings, HBA1C Levels and demographic data was extracted from CHS computer Data on medical treatment in HRP clinic was retrieved from visits in the researcher clinic. We evaluated measurement and Level of HBA1C within 3 months of fertility treatment; and compared it between the two groups.
  
  
  RESULTS
  There were 230 fertility treatment cycles in 83 diabetic women; 10 women were treated in the HRP clinic. Median HBA C was significantly lower 6.1% in the HRP group compared to 7.1% in women who received usual care (P < 0.05]. HBA1C Level was recorded within 3 months of fertility treatment in 84.2% of cycles in the HRP group compared to 52.6% of cycles in the usual care group (P < 0.05). Furthermore, HBA1C < 7.0% was found in 68.4% of cycles in women in the HRP clinic compared to only 24.0% of cycles in the other group [P < 0.05).
  
  
  CONCLUSIONS
  The medical care of diabetic women undergoing fertility treatment needs improvement. Many women undergo fertility treatment despite poor glycemic control. Referral to HRP clinic improves diabetic control and can improve pregnancy outcome.
authors.affiliation: Department of Obstetrics and Gynecology, The Lady Davis Carmel Medical Center, Rappaport Faculty of Medicine, Technion, Israel. moranpaz@gmail.com
authors.forename: Moran
authors.initials: M
authors.lastname: Paz
authors.forename: Ron
authors.initials: R
authors.lastname: Auslander
authors.forename: Shlomit
authors.initials: S
authors.lastname: Riskin-Mashiah
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000592:standards; D001786:Blood Glucose / Q000378:metabolism; D003695:Delivery of Health Care / Q000592:standards*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007557:Israel; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics; D018566:Pregnancy, High-Risk; D012017:Referral and Consultation; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin